Posterior pituitary tumors: clinicopathological features and patient outcomes from a referral pituitary center

02.07.2026

Jacek Kunicki, Barbara Buchalska, Jakub Skiba, Wiesława Grajkowska, Maria Maksymowicz

Abstract

Introduction: Posterior pituitary tumors (PPTs) are rare pathologies universally identified by positive immunoreactivity for thyroid transcription factor-1 (TTF-1). They include four subtypes: pituicytoma (PC), granular cell tumor (GCT), spindle cell oncocytoma (SCO), and sellar ependymoma (SE). Because these tumors are rare, data regarding the optimal treatment strategy and prognosis are lacking. The aim of our study was to describe a large single-center cohort of patients with PPTs.

Material and methods: We retrospectively analyzed data from 15 patients diagnosed with PPTs among 2108 patients who underwent pituitary surgery at our institution between 2009 and 2024, examining their clinical presentations, imaging studies, surgical techniques, and recovery trajectories. The mean age was 50.5 years (range, 18–74 years). The mean follow-up time was 6.4 years (range, 0–15 years).

Results: We describe eight cases of PC, four of SCO, and three of GCT. The most common symptoms were visual impairment (46.7%) and headache (40.0%). Thirteen patients (86.7%) underwent endoscopic transsphenoidal surgery, ten of whom achieved gross total resection (GTR).

Conclusions: The endoscopic transsphenoidal approach has proven to be a safe and highly effective method for achieving GTR in patients with PPTs. Spindle cell oncocytoma, with a higher level of vascularization than PC and GCT, poses a greater risk of surgical complications and may result in non-GTR.

Keywords: posterior pituitary tumorsendoscopic endonasal resection

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