Secondary vs. primary pituitary xanthogranulomas: which yellow is more mellow?

Autor:	Miljic D; Faculty of Medicine, University of Belgrade, Belgrade 11000, Serbia.; Clinic for Endocrinology, Diabetes and Metabolic Diseases, University Clinical Center of Serbia, Belgrade 11000, Serbia., Pekic S; Faculty of Medicine, University of Belgrade, Belgrade 11000, Serbia.; Clinic for Endocrinology, Diabetes and Metabolic Diseases, University Clinical Center of Serbia, Belgrade 11000, Serbia., Doknic M; Faculty of Medicine, University of Belgrade, Belgrade 11000, Serbia.; Clinic for Endocrinology, Diabetes and Metabolic Diseases, University Clinical Center of Serbia, Belgrade 11000, Serbia., Stojanovic M; Faculty of Medicine, University of Belgrade, Belgrade 11000, Serbia.; Clinic for Endocrinology, Diabetes and Metabolic Diseases, University Clinical Center of Serbia, Belgrade 11000, Serbia., Ilic S; Clinic for Endocrinology, Diabetes and Metabolic Diseases, University Clinical Center of Serbia, Belgrade 11000, Serbia., Djurovic MN; Faculty of Medicine, University of Belgrade, Belgrade 11000, Serbia.; Clinic for Endocrinology, Diabetes and Metabolic Diseases, University Clinical Center of Serbia, Belgrade 11000, Serbia., Jemuovic Z; Clinic for Endocrinology, Diabetes and Metabolic Diseases, University Clinical Center of Serbia, Belgrade 11000, Serbia., Milojevic T; Clinic for Neurosurgery, University Clinical Center of Serbia, Belgrade 11000, Serbia., Milicevic M; Faculty of Medicine, University of Belgrade, Belgrade 11000, Serbia.; Clinic for Neurosurgery, University Clinical Center of Serbia, Belgrade 11000, Serbia., Jovanovic M; Faculty of Medicine, University of Belgrade, Belgrade 11000, Serbia.; Center for Magnetic Resonance Imaging, University Clinical Center of Serbia, Belgrade 11000, Serbia., Medic Stojanoska M; University of Novi Sad, Faculty of Medicine, Clinic for Endocrinology, Diabetes and Metabolic Diseases, Clinical Center of Vojvodina, Novi Sad 21000, Serbia., Carić B; Faculty of Medicine, University of Banja Luka, University Clinical Center of Republic of Srpska, Banja Luka 78101, Bosnia and Herzegovina., Radic N; Clinic for Endocrinology, Diabetes and Metabolic Diseases, University Clinical Center of Serbia, Belgrade 11000, Serbia., Medenica S; School of Medicine, University of Montenegro, Podgorica, Montenegro, Department of Endocrinology, Internal Medicine Clinic, Clinical Center of Montenegro, Podgorica 81110, Montenegro., Manojlovic Gacic E; Institute of Pathology, Faculty of Medicine, University of Belgrade, Belgrade 11000, Serbia., Petakov M; Faculty of Medicine, University of Belgrade, Belgrade 11000, Serbia.; Clinic for Endocrinology, Diabetes and Metabolic Diseases, University Clinical Center of Serbia, Belgrade 11000, Serbia.
Jazyk:	angličtina
Zdroj:	Endocrine journal [Endocr J] 2024 Mar 28; Vol. 71 (3), pp. 285-293. Date of Electronic Publication: 2024 Jan 27.
DOI:	10.1507/endocrj.EJ23-0398
Abstrakt:	Pituitary xanthogranulomatomas (XG) are a rare pathological entity caused by accumulation of lipid laden macrophages and reactive granuloma formation usually triggered by cystic fluid leakage or hemorrhage. Our aim was to compare clinical characteristics and presenting features of patients with secondary etiology of XG and those with no identifiable founding lesion (primary -"pure" XG) in order to gain new insights into this rare pituitary pathology. In a retrospective review of 714 patients operated for sellar masses, at tertiary center, we identified 16 (2.24%) with histologically confirmed diagnosis of pituitary XG over the period of 7 years (2015-2021). Patients were further analyzed according to XG etiology: "pure"- XG (n = 8) with no identifiable founding lesion were compared to those with histological elements of pituitary tumor or cyst - secondary XG (n = 8). We identified 16 patients (11 male), mean age 44.8 ± 22.3 years, diagnosed with pituitary XG. Secondary forms were associated with Ratke's cleft cyst (RCC, n = 2) and pituitary adenoma (PA, n = 6). The most common presenting features in both groups were hypopituitarism (75%), headache (68.5%) and visual disturbances (37.5%). Predominance of male sex was noted (males 68.75%, females 31.25%), especially in patients with primary forms. Patients with primary pituitary XG were all males (p = 0.0256) and more frequently affected by panhypopituitarism (87.5% vs. 25%, p = 0.0406) compared to patients with secondary causes. Hyperprolactinemia was noted in pituitary tumor group with secondary etiology only (p = 0.0769). Majority of lesions were solid on magnetic resonance imaging - MRI (81.25%). Distinct clinical phenotype was observed dependent on the etiology of XG.
Databáze:	MEDLINE
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