We present a rare case of spindle cell oncocytoma (SCO) of the sella turcica with malignant histologic features and rapid progression. A 42-year-old woman experienced bilateral blurred vision and was preoperatively misdiagnosed as having a pituitary macroadenoma on magnetic resonance imaging. After surgery, SCO was diagnosed by the histopathologic features of interlacing fascicles of spindle tumor cells with finely granular, eosinophilic cytoplasm. Focal anaplastic changes and necrosis were present. Immunohistochemically, the tumor cells were positive for vimentin, epithelial membrane antigen, S-100, galectin-3, and thyroid transcription factor 1. Four months later, the tumor had progressed, and second surgery with adjuvant radiotherapy was performed; the patients remains under observation. In this report, we proposed distinctive radiologic features for differential diagnosis between SCO and other pituitary tumors.
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Treatment modalities and outcomes of granular cell tumors and spindle cell oncocytomas of the pituitary gland: an analysis of two national cancer databases A. Yohan Alexander, Giorgos Michalopoulos, Panagiotis Kerezoudis, Jamie J. Van Gompel, Michael J. Link, Maria Peris-Celda Acta Neurochirurgica.2024;[Epub] CrossRef
Spindle cell oncocytoma, a misdiagnosed rare entity of the pituitary – A case report with review of literature and special emphasis on the morphological differentials Gittwa Vatsaraj Kottangal, Lilly Madhavan, Shalini Kuruvilla, Kavitha Kanjirakadu Parameswaran, Shehla Basheer Kollathodi Indian Journal of Pathology and Oncology.2021; 8(4): 533. CrossRef
Fibromatosis can occur at various sites, but intracranial fibromatosis is exceptionally rare. Here, we report a case of intracranial fibromatosis arising in the suprasellar area of a 52-year-old woman who had undergone a surgery at that site. A computed tomography scan revealed a heavily calcified, highly enhancing, poorly demarcated mass in the left sellar area that extended into the left suprasellar, parasellar areas, and orbital apex and completely encased the left distal inferior cerebral artery. Histologic and immunohistochemical features were compatible with those of fibromatosis, although the cellularity was focally higher than usual. The etiology of extra-abdominal fibromatosis is unknown, but physical injuries such as trauma and irradiation have been reported to be associated with its occurrence. Although fibromatosis is rare in the intracranial area, it should be considered as a differential diagnosis when an intracranial mass occurs at a previously injured site.
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Infantile Intracranial Aggressive Fibromatosis: Report of Two Cases with a Review of the Literature Baocheng Wang, Jie Ma, Huiming Jin Pediatric Neurosurgery.2012; 48(3): 181. CrossRef
Primary intrasellar schwannomas or neurilemmomas occur rarely and mimic pituitary adenoma, radiologically and clinically. The authors describe the 6th case of primary intrasellar schwannoma mimicking a nonfunctioning pituitary macroadenoma, clinically as well as radiologically. Light microscopically, the present case did not show the typical histology of conventional schwannoma and the confirmative diagnosis was made with the aid of immunohistochemistry and electron microscope. Here, we review the possible hypotheses for pathogenesis of sellar schwannomas on unusual locations.