Intraventricular pituicytoma: illustrative case.
Takashi Hanyu1, Ryota Ishibashi1, Kazushi Kitamura1
1Departments of Neurosurgery, Medical Research Institute, Kitano Hospital, Osaka, Japan.
Journal of Neurosurgery. Case Lessons
|August 26, 2024
Summary
Intraventricular pituicytoma, a rare tumor, can occur without affecting the pituitary stalk. This case highlights its potential origin from the hypothalamus and the critical need to manage bleeding during surgery.
Area of Science:
- Neuro-oncology
- Endocrinology
- Neurosurgery
Background:
- Pituicytoma is a rare glial neoplasm originating from pituicytes in the neurohypophysis or infundibulum.
- Typically found in the sella and suprasellar regions, intraventricular pituicytoma without infundibular involvement is exceptionally rare.
Purpose of the Study:
- To report a rare case of intraventricular pituicytoma.
- To discuss its origin, diagnostic challenges, and surgical management.
- To review the literature on intraventricular pituicytoma.
Main Methods:
- Case presentation of a 69-year-old man with progressive dementia.
- MRI revealed an intraventricular mass in the anterior third ventricle, with no involvement of the sella, suprasellar area, or infundibulum.
- Tumor removal via transcallosal transchoroidal approach, followed by histopathological analysis including thyroid transcription factor-1 (TTF-1) immunohistochemistry and DNA methylation profiling.
Main Results:
- A 69-year-old male presented with dementia and an isolated intraventricular mass.
- Histopathology showed bipolar cells with TTF-1 immunoreactivity. DNA methylation analysis supported a diagnosis within the pituicytoma/granular cell tumor/spindle cell oncocytoma class.
- A systematic review identified only 5 previously reported cases of intraventricular pituicytoma.
Conclusions:
- Intraventricular pituicytoma can arise independently of the infundibulum, potentially from hypothalamic tuber cinereum pituicytes.
- The hypervascular nature necessitates meticulous control of intraoperative bleeding, especially concerning the adjacent hypothalamus.
- This case expands the understanding of pituicytoma localization and surgical considerations.
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