TTF1-positive posterior pituitary tumors: a single-center experience of 10 years.

IF 3 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Endocrine Pub Date : 2025-04-03 DOI:10.1007/s12020-025-04214-x

Elisa Lamback, Aline Helen da Silva Camacho, Anna Clara Castro Araujo, Luiz Eduardo Wildemberg, Ferdinand Duenas Cabrera Filho, Felipe Andreiuolo, Leandro Kasuki, Nina Ventura, Leila Chimelli, Mônica R Gadelha

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引用次数: 0

Abstract

Purpose: Primary TTF1-positive posterior pituitary tumors (PPT) are uncommon and frequently misdiagnosed preoperatively. This study aims to describe our experience with PPT, examining clinical, radiological and histopathological data, as well as surgical and clinical outcomes.

Methods: We conducted a retrospective review of medical records from patients treated at a single neurosurgical center between 2013 and 2023. Immunohistochemistry for TTF-1 was performed using AB_1158934.

Results: Nine PPT were included: 6 spindle cell oncocytomas (SCO), 2 granular cell tumor (GCT) and 1 pituicytoma. The median age was 53 years (range 34-70), with six (66.7%) patients being male. Most patients presented preoperatively with panhypopituitarism (8 cases), visual impairment (7 cases) and headache (7 cases). The median largest tumor diameter of 2.7 cm (range 1.7-5.4 cm) and PPT appeared isointense on T1W. SCO typically manifested as large intrasellar tumors with suprasellar extension and pronounced contrast-enhancement. GCT and pituicytoma were predominantly suprasellar lesions, with GCT showing a characteristic "star-like crack" pattern. Surgical outcomes varied, with the minority of successful cases involving SCO, known for their hypervascularity and firm consistency.

Conclusion: PTT constituted 0.6% of sellar/suprasellar surgeries at our center. SCO should be suspected if a large and significant contrast-enhancement lesion is seen, and GCT if there is a suprasellar tumor with a "star-like crack" pattern. Surgical outcomes were not favorable: the majority of cases showed subtotal resection requiring adjuvant radiotherapy. Long-term follow-up is crucial due to the limited curative outcomes observed in most patients.

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ttf1阳性垂体后叶肿瘤：10年的单中心经验。

目的：原发性ttf1阳性垂体后叶肿瘤（PPT）并不常见，且术前常被误诊。本研究旨在描述我们使用PPT的经验，检查临床、放射学和组织病理学资料，以及手术和临床结果。方法：我们对2013年至2023年在单一神经外科中心治疗的患者的医疗记录进行了回顾性分析。使用AB_1158934对TTF-1进行免疫组化。结果：9例PPT：梭形细胞癌（SCO） 6例，颗粒细胞瘤（GCT） 2例，垂体细胞瘤1例。中位年龄为53岁（34-70岁），6例（66.7%）为男性。多数患者术前表现为垂体功能减退（8例）、视力障碍（7例）、头痛（7例）。T1W中位最大肿瘤直径为2.7 cm（范围为1.7 ~ 5.4 cm），与PPT呈等影。SCO典型表现为大鞍内肿瘤，鞍上延伸和明显的对比增强。GCT和垂体瘤以鞍上病变为主，GCT表现为特征性的“星状裂隙”。手术结果各不相同，少数成功的病例涉及SCO，以其血管增生和坚固的一致性而闻名。结论：PTT占本中心鞍上手术的0.6%。如果看到一个大而明显的对比增强病变，则应怀疑SCO，如果发现鞍上肿瘤呈“星状裂缝”模式，则应怀疑GCT。手术结果不佳：大多数病例显示次全切除需要辅助放疗。由于大多数患者的疗效有限，长期随访至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Endocrine ENDOCRINOLOGY & METABOLISM-

CiteScore

6.50

自引率

5.40%

发文量

295

审稿时长

1.5 months

期刊介绍： Well-established as a major journal in today’s rapidly advancing experimental and clinical research areas, Endocrine publishes original articles devoted to basic (including molecular, cellular and physiological studies), translational and clinical research in all the different fields of endocrinology and metabolism. Articles will be accepted based on peer-reviews, priority, and editorial decision. Invited reviews, mini-reviews and viewpoints on relevant pathophysiological and clinical topics, as well as Editorials on articles appearing in the Journal, are published. Unsolicited Editorials will be evaluated by the editorial team. Outcomes of scientific meetings, as well as guidelines and position statements, may be submitted. The Journal also considers special feature articles in the field of endocrine genetics and epigenetics, as well as articles devoted to novel methods and techniques in endocrinology. Endocrine covers controversial, clinical endocrine issues. Meta-analyses on endocrine and metabolic topics are also accepted. Descriptions of single clinical cases and/or small patients studies are not published unless of exceptional interest. However, reports of novel imaging studies and endocrine side effects in single patients may be considered. Research letters and letters to the editor related or unrelated to recently published articles can be submitted. Endocrine covers leading topics in endocrinology such as neuroendocrinology, pituitary and hypothalamic peptides, thyroid physiological and clinical aspects, bone and mineral metabolism and osteoporosis, obesity, lipid and energy metabolism and food intake control, insulin, Type 1 and Type 2 diabetes, hormones of male and female reproduction, adrenal diseases pediatric and geriatric endocrinology, endocrine hypertension and endocrine oncology.