title: Surgical management of pituicytomas: case series and comprehensive literature review.
abstract: OBJECTIVE
  Pituicytomas are rare neoplasms that typically present as solid, noninfiltrative tumors occupying the sella and/or suprasellar space for which there is no consensus on optimal surgical management. We aimed to define a preferred surgical strategy for these tumors based on our clinical experience and comprehensive review of the world literature.
  
  
  METHODS
  Case series and review of the literature.
  
  
  METHODS
  We documented the clinical, radiographic, and surgical findings of three patients with pituicytoma treated at our institution, as well as complications and long-term outcomes. A comprehensive review of the medical literature identified all cases of pituicytoma for which data regarding surgical approach, outcome and complications could be extracted. We compared our results with published data.
  
  
  RESULTS
  All three cases at our institution achieved gross total removal. Two patients underwent an expanded endoscopic endonasal transsphenoidal and transplanum (EETS-TP) approach, while one tumor was removed via craniotomy. Post-operatively all patients developed pan-hypopitutarism. The patient undergoing craniotomy suffered profound visual loss but no other neurological complications were noted. A literature review identified 67 reported cases of pituicytoma. Surgical data was available in 60 cases. Surgical approach was documented in 57 patients. Sixty-three surgeries were performed in which approach and extent of resection was available. Gross total removal was obtained in 33 % of craniotomies, 42 % of transsphenoidal procedures, and 100 % of expanded transsphenoidal procedures. Neurological complications including visual loss, hemiparesis and cranial nerve palsies were reported after craniotomy, but not after transsphenoidal approaches. Overall EETS-TP approaches were associated with the highest rate of gross total removal and no visual or neurological complications.
  
  
  CONCLUSIONS
  EETS-TP surgery is the preferred strategy for surgical removal of pituicytoma. EETS-TP and transsphenoidal approaches are associated with higher rates of gross total removal and lower rates of neurological complications than craniotomy. Gross total removal should be the intended goal of surgery.
authors.affiliation: Department of Neurosurgery, Peking Union Medical College Hospital, Beijing, China.
authors.forename: Ming
authors.initials: M
authors.lastname: Feng
authors.forename: John D
authors.initials: JD
authors.lastname: Carmichael
authors.forename: Vivien
authors.initials: V
authors.lastname: Bonert
authors.forename: Serguei
authors.initials: S
authors.lastname: Bannykh
authors.forename: Adam N
authors.initials: AN
authors.lastname: Mamelak
mesh_terms: D003399:Craniotomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000175:diagnosis / Q000601:surgery*
references.citation: J Clin Neurosci. 2010 Jul;17(7):938-43
references.pmid: 20403698
references.citation: J Neurosurg. 1997 Jul;87(1):131
references.pmid: 9202281
references.citation: Childs Nerv Syst. 2012 Jan;28(1):11-2
references.pmid: 22094360
references.citation: Ann Diagn Pathol. 2004 Oct;8(5):290-4
references.pmid: 15494936
references.citation: Oncol Lett. 2011 Jan;2(1):37-41
references.pmid: 22870125
references.citation: Br J Neurosurg. 2013 Jun;27(3):374-82
references.pmid: 23181428
references.citation: Pituitary. 2012 Dec;15 Suppl 1:S10-6
references.pmid: 20945102
references.citation: J Neurosurg. 2003 Feb;98(2):404-6
references.pmid: 12593630
references.citation: Surg Neurol Int. 2010 Dec 13;1:79
references.pmid: 21206895
references.citation: Neurol India. 2010 Sep-Oct;58(5):799-801
references.pmid: 21045523
references.citation: AJNR Am J Neuroradiol. 2005 Aug;26(7):1858-61
references.pmid: 16091544
references.citation: J Neurosurg. 1982 Apr;56(4):594-6
references.pmid: 7062133
references.citation: Surg Neurol Int. 2011;2:116
references.pmid: 21886889
references.citation: Neurosurgery. 2011 Sep;69(3):630-43; discussion 643
references.pmid: 21499159
references.citation: J Neurosurg. 1987 Nov;67(5):768-72
references.pmid: 3668648
references.citation: Ryoikibetsu Shokogun Shirizu. 2000;(28 Pt 3):218-9
references.pmid: 11043233
references.citation: J Comp Pathol. 2008 Aug-Oct;139(2-3):67-80
references.pmid: 18621384
references.citation: N Engl J Med. 2008 Dec 25;359(26):2824
references.pmid: 19109577
references.citation: AJNR Am J Neuroradiol. 2011 Dec;32(11):2067-72
references.pmid: 21960498
references.citation: Neurosurgery. 1994 Aug;35(2):314-7; discussion 317
references.pmid: 7969842
references.citation: Pathol Int. 2011 Oct;61(10):598-602
references.pmid: 21951670
references.citation: Neurosurgery. 2008 Jul;63(1):E173-4; discussion E174
references.pmid: 18728556
references.citation: Brain Pathol. 2007 Jul;17(3):319-24
references.pmid: 17598825
references.citation: AJNR Am J Neuroradiol. 2006 Sep;27(8):1639-42
references.pmid: 16971602
references.citation: Hum Pathol. 2009 Mar;40(3):435-40
references.pmid: 18992914
references.citation: Pathol Res Pract. 2013 Jan 15;209(1):52-8
references.pmid: 23237862
references.citation: World Neurosurg. 2014 Jul-Aug;82(1-2):186-95
references.pmid: 23403355
references.citation: Neurosurgery. 2004 Mar;54(3):753-7; discussion 757-8
references.pmid: 15028154
references.citation: Pathol Int. 2005 Nov;55(11):745-9
references.pmid: 16271088
references.citation: J Neurol Surg A Cent Eur Neurosurg. 2013 Mar;74(2):101-8
references.pmid: 23319331
references.citation: Pituitary. 2012 Jun;15(2):227-36
references.pmid: 21597973
references.citation: World Neurosurg. 2012 Feb;77(2):329-41
references.pmid: 22501020
references.citation: J Neurosurg. 1958 Sep;15(5):481-8
references.pmid: 13576191
references.citation: Case Rep Ophthalmol. 2012 May;3(2):190-6
references.pmid: 22740829
references.citation: Neuroradiology. 2002 Feb;44(2):123-5
references.pmid: 11942363
references.citation: Ultrastruct Pathol. 2001 Jul-Aug;25(4):309-12
references.pmid: 11577776
references.citation: Pituitary. 2006;9(1):53-8
references.pmid: 16703409
references.citation: No To Shinkei. 1967 Oct;19(10):1015-20
references.pmid: 5300544
references.citation: Acta Neuropathol. 2002 Sep;104(3):313-9
references.pmid: 12172918
references.citation: J Med Case Rep. 2012 Sep 18;6:306
references.pmid: 22989192
references.citation: Arch Pathol Lab Med. 2001 Apr;125(4):527-30
references.pmid: 11260629
references.citation: Br J Radiol. 2011 Mar;84(999):e55-7
references.pmid: 21325358
references.citation: World Neurosurg. 2012 Jul;78(1-2):191.E1-7
references.pmid: 22120271
references.citation: Am J Surg Pathol. 2000 Mar;24(3):362-8
references.pmid: 10716149
references.citation: Neurocirugia (Astur). 2012 Jul;23(4):165-9
references.pmid: 22796297
references.citation: Neurol Med Chir (Tokyo). 2006 Mar;46(3):152-6
references.pmid: 16565586
references.citation: Clin Neuropathol. 2010 May-Jun;29(3):127-33
references.pmid: 20423685
references.citation: Diagn Cytopathol. 2005 Oct;33(4):255-7
references.pmid: 16138377
references.citation: Brain Pathol. 2012 Nov;22(6):871-4
references.pmid: 23050875
references.citation: Arch Pathol Lab Med. 2010 Jul;134(7):1063-9
references.pmid: 20586639
references.citation: Acta Neurochir (Wien). 2012 Apr;154(4):649-57; discussion 657
references.pmid: 22120541
references.citation: J Comput Assist Tomogr. 2010 Sep-Oct;34(5):757-61
references.pmid: 20861781