RARE-08SPINDLE CELL ONCOCYTOMA OF THE PITUITARY GLAND: CASE REPORT AND LITERATURE REVIEW

Abstract

INTRODUCTION: Spindle cell oncocytoma of the pituitary gland (SCO) describes a rare and relatively recently described non-endocrine neoplasm of the adenohypophysis that occurs in adults. These lesions tend to follow a clinically benign course and are designated as grade I by theWorld Health Organization (WHO) 2007 classification of tumors of the central nervous system. Diagnosis is often difficult, as clinically these masses can present very similarly to nonfunctional pituitary macroadenomas and are radiologically indistinguishable from adenomas and lymphocytic hypophysitis. To the best of our knowledge, there are 22 prior reported cases of SCO. CASE: A 59-year-old man presented with progressive headache for 3-weeks duration. On work up he was diagnosed with nonfunctional pituitary macroadenoma, and underwent complete transsphenoidal resection of the tumor. Histopathology ultimately revealed SCO. He has been stable without evidence of recurrence for 4 years. CONCLUSION: Spindle cell oncocytomas present similarly to nonfunctional adenomas and diagnosis is often difficult without surgical pathology. Despite this, SCO carry an increased risk of recurrence, and meticulous immunohistochemistry is warranted to prevent misdiagnosis after surgery. SCO should be considered in the differential diagnosis of sellar-region lesions.