Spindle Cell Oncocytoma Of Adenohypophysis Research Articles

Trans-nasal trans-sphenoidal endoscopic resection of spindle cell oncocytoma of adenohypophysis: The first case report in a child and a review of literature

Spindle cell oncocytoma (SCO) is a rare tumor of adenohypophysis, arising from the sellar region. So far, about 35 cases of SCO in the sellar region have been reported. In this report, we present the first case of pediatric SCO and review the literature concerning the tumor origin, clinical presentations, radiological features, and treatment modalities. An 8-year-old male was referred to our clinic with progressive visual loss in the left eye and headache over the past 6 months. Cranial magnetic resonance imaging revealed a solid adenohypophysis mass with suprasellar extension, as well as compression and displacement of the optic chiasm. The patient underwent endoscopic trans-sphenoidal resection of the tumor. The tumor was diagnosed as SCO based on the histological study. He did not receive radiation therapy. The patient's condition remained stable, with no radiological recurrence in the past follow-up 2 years after the surgery.

Spindle cell oncocytoma of adenohypophysis: report of a rare pituitary tumor

Spindle cell oncocytoma of adenohypophysis: report of a rare pituitary tumor

Spindle cell oncocytoma of adenohypophysis: Cytogenetics and β-catenin findings with pathology differential diagnosis and review of the literature

Spindle cell oncocytoma (SCO) is an extremely rare neoplasm arising in the anterior pituitary. We report comprehensive pathological description of a case of SCO in a 60year-old male who presented with nausea, vomiting and severe hyponatremia, and pan hypopituitarism. Magnetic resonance imaging (MRI) showed a 3.1×2.3×2.0cm homogeneously enhancing bilobed mass within the sella turcica and suprasellar cistern. Intraoperative frozen section and touch imprint cytology showed cohesive spindle cells with abundant oncocytic cytoplasm. Histologic sections revealed the tumor was composed of interlacing fascicles of compact spindled cells with abundant dense oncocytic cytoplasm. There was no mitosis or necrosis present. Ki-67 index varied in areas, with an average of 3%. By immunohistochemistry (IHC), the tumor cells were negative for Cam5.2, AE1/3, neurofilament (NF), NeuN, glial fibrillary acidic protein (GFAP) and synaptophysin, and strongly positive for vimentin, TTF-1 and EMA. S-100 showed focal weakly positivity. By electron microscopy (EM), the cytoplasm of the spindle cells contained numerous abundant, back-to-back, uniform, round, normal-sized mitochondria with long and lamellar cristae. Beta-catenin showed diffuse membranous and partial cytoplasmic positivity. Cytogenetic analysis showed extra copies of chromosome 1 (74%, up to 8 copies), and loss of chromosome 2 (35%). The histogenesis, classification and differential diagnosis are discussed.

Spindle cell oncocytoma of adenohypophysis: Report of a case and immunohistochemical review of literature

We present a case of spindle cell oncocytoma (SCO) of the adenohypophysis in a 70-year-old Vietnamese male. The patient was admitted to Cho Ray Hospital after suffering from headache and visual disturbance for 6 months. Clinicians detected a 60×55×45mm3 mass located in the suprasellar-sellar region. Histopathologically, the resected tumor was composed of spindle cells with oncocytic appearance. Immunohistochemical examination revealed expression of anti-mitochondria antibody (AMA), vimentin, thyroid transcription factor 1 (TTF-1), epithelial membrane antigen (EMA) and galectin-3. These histologic and immunohistochemical findings are suggestive of SCO.

Spindle Cell Oncocytoma of the Adenohypophysis

The recently described "spindle cell oncocytoma of the adenohypophysis" is a very rare and often misdiagnosed entity. A benign biologic behavior has been suggested based on the absence of recurrences with a median follow-up of 3 years. Herein, we present 2 cases of recurrent spindle cell oncocytomas. One patient is a 71-year-old woman (case no. 1) and the other a 76-year-old man (case no. 2). Recently, both underwent transsphenoidal reexploration for recurrent "pituitary adenoma." Patient no. 1 had initial surgery 11 years ago with a recurrence after 3 years that was initially stable. Ultimately, a partial resection was performed after compression of optic pathways by the tumor, and approximately 1 year later, re-resection was carried out. Patient no. 2 had initial surgery 10 years ago with recurrence and resection after 3 years. He recently presented with a large mass that involved the pituitary fossa and base of the skull, with extension into the nasopharynx and nasal cavity. The primary and recurrent lesions of both cases showed similar architecture with interlacing fascicles of spindle cells that alternated with areas of epithelioid-like cells that exhibited eosinophilic, granular cytoplasm. Neoplastic cells were positive for vimentin, S-100 protein, and epithelial membrane antigen, and negative for glial fibrillary acidic protein, chromogranin, and pituitary hormones. Increased mitotic activity was noted in 1 lesion (case no. 2), although both cases had high Ki-67 indices (18% and 20%, respectively). The ultrastructural features of both cases were characteristic with intracytoplasmic accumulations of large mitochondria. The histopathologic features of these lesions are consistent with spindle cell oncocytoma of the adenohypophysis. In summary, we are reporting 2 cases of recurrent spindle cell oncocytoma of adenohypophysis with longer follow-up than previously published cases, suggesting the possibility of a more aggressive behavior than has been initially considered.