Clinicopathological Analysis Of 26 Cases Of Posterior Pituitary Tumor And Sellar Neuron Tumor

Objective:The posterior pituitary tumors(PPTs)and sellar region neuron tumors are very rare,and most of them are reported as cases in the previous literature.In order to increase the understanding of the above tumors,the epidemiological characteristics,clinical symptoms and imaging manifestations of 26 cases of PPTs and sellar region neuron tumor were reported,and the histological morphology and immunohistochemical expression of the above tumors were studied under the microscope.To study the factors influencing the recurrence of PPTs and sellar neuron tumors and their prognosis.Methods:From 2016 to 2022 in the First Affiliated Hospital of China Medical University,there were 22 cases(16 cases of pituitary cell tumor,4 cases of granular pituitary cell tumor,2 cases of eosinophilic pituitary cell tumor)and 4 cases of sellar neuron tumor(3 cases of mixed pituitary adenoma-ganglioneuroma and 1 case of neurocytoma)diagnosed as PPTs.Based on the patient’s medical records,clinical and pathological data,the epidemiological characteristics,clinical symptoms,imaging manifestations,histopathological manifestations,immunohistochemical expression,treatment and prognosis of 26 patients were summarized.Follow-up the recurrence of patients by telephone contact.Results:1.There are 22 cases of 1.PPTs,with an average onset age of 45.8 years and a median onset age of 51(11-70)years.There were 8 males and 14 females,the ratio of male to female was 1:1.75;The main clinical symptoms are:headache and dizziness(13/22)(59.1%),visual impairment(45.5%),fatigue(22.7%),amenorrhea or decreased libido(4/22),enlarged hands and feet or facial changes(9.1%),and depression.The main surgical methods were as follows:19/22(86.4%)of the tumors in the sellar region were resected by transsphenoidal approach under microscope and 3/22(13.6%)of the lesions in the sellar region were resected by craniotomy;Follow-up time ranged from 1 to 75 months.Among the 22 cases of posterior pituitary tumors,2 patients were lost,18 patients had no recurrence,and 2 patients had recurrence(in the 25th and 34th months respectively),with an overall recurrence rate of 9.1%.Histological features of pituitary cytoma and spindle cell eosinophilia are mostly spindle cells arranged alternately or in bundles,while granular cell tumor in sellar region is large polygonal cells with eccentric nucleus,and the cytoplasm of all three cells has moderate to rich eosinophilic characteristics.The expression of TTF-1 in PPTs nuclei was strongly positive.The sex,age,Ki-67 and operation mode of PPTs patients had no significant influence on the recurrence(P>0.05).2.There were 4 cases of hypothalamic neuronal tumors,with an average onset age of 48.3 years and a median onset age of 51(34-57)years.Among them,1 case was male and 3 cases were female,the ratio of male to female was 1:1.3;The main clinical symptoms are:headache and dizziness 3/4(75.0%),visual impairment 2/4(50.0%),hand and foot thickening or facial change 1/4(25.0%);The surgical methods were 4/4(100.0%)of the tumors in the sellar region by transnasal transsphenoidal approach under microscope.Follow-up time ranged from 1 to 89 months.Of the 4 patients,3 patients had no recurrence and 1 patient had recurrence(at the 43rd month),with an overall recurrence rate of 25.0%.Under the histological microscope,the characteristics of sellar neuron tumors are large and irregular ganglion-like cells,or small round neurons with medium size arranged in sheets,and neuron markers such as Syn,S-100 and NeuN are positive.The pituitary transcription factor(such as Pit-1)is expressed in the adenoma component of mixed pituitary adenoma-ganglioneuroma.Conclusion:1.PPTs and sellar neuron tumors are common in middle-aged and elderly people(30-69 years old age group),and the incidence of female is slightly higher than that of male.2.TTF-1,S-100,Syn,NeuN and GFAP are of great significance for the diagnosis of PPTs and sellar region neuronal tumors.3.The prognosis of 3.PPTs and sellar neuron tumor is good,and there is no distant metastasis.The treatment method is total tumor resection and regular follow-up.