Adenohipofizin ��si H�creli Onkositomu: Atipik Histomorfolojik �zellikler ve Erken N�ks G�steren Bir Olgu

Onak Kandemir, Nil�fer; Do�an G�n, Banu; Bahad�r, Burak; G�l, �anser; �z, �lker; Bar���k, Nagehan �zdemir

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Adenohipofizin ��si H�creli Onkositomu: Atipik Histomorfolojik �zellikler ve Erken N�ks G�steren Bir Olgu [South Clin Ist Euras]

South Clin Ist Euras. 2018; 29(1): 53-59 | DOI: 10.14744/scie.2017.29392

Adenohipofizin ��si H�creli Onkositomu: Atipik Histomorfolojik �zellikler ve Erken N�ks G�steren Bir Olgu

Nil�fer Onak Kandemir¹, Banu Do�an G�n², Burak Bahad�r², �anser G�l³, �lker �z⁴, Nagehan �zdemir Bar��k⁵
¹Patoloji B�l�m�, Ankara Atat�rk E�itim ve Ara�t�rma Hastanesi, Ankara
²Patoloji B�l�m�, B�lent Ecevit �niversitesi T�p Fak�ltesi, Zonguldak
³Beyin Cerrahisi B�l�m�, B�lent Ecevit �niversitesi T�p Fak�ltesi, Zonguldak
⁴Radyoloji B�l�m�, B�lent Ecevit �niversitesi T�p Fak�ltesi, Zonguldak
⁵T�bbi Patoloji B�l�m�,Sa�l�k Bilimleri �niversitesi T�p Fak�ltesi, �stanbul

Adenohipofizin i�si h�creli onkositomu (SCO), olduk�a nadir g�r�len, klinikopatolojik a��dan �nemli ay�r�c� tan� zorluklar�na neden olan ve biyolojik davran��na y�nelik verilerin s�n�rl� olmas� nedeniyle hasta y�netiminde zorluklar i�eren bir sellar b�lge t�m�r�d�r. G�rme bozuklu�u yak�nmas� ile ba�vuran 61 ya��ndaki erkek hastada, sellar/suprasellar yerle�imli kitle saptand� ve ameliyat edildi. Operasyon sonras� ��nc� ve alt�nc� ayda hastan�n yak�nmalar�n�n devam etmesi, t�m�r�n boyutlar�nda artma olmas� �zerine iki kez re-operasyon uyguland�. Histopatolojik de�erlendirmede i�si- epitelioid morfolojide, onkositik sitoplazmal� t�m�r h�crelerinin fasik�ller/tabakalar/ps�doasiner yap�lar olu�turdu�u g�zlendi. Neoplastik h�crelerde vimentin, EMA, Galektin 3, TTF-1 ve AMA ile pozitif, epitelyal belirleyiciler, hipofiz hormonlar� ve n�roendokrin mark�rlar ile negatif imm�noreaktivite g�zlendi. N�kslere ait materyallerde, ilk biyopsi �rne�ine g�re, pleomorfizm, atipi ve mitotik aktivitede art�� dikkati �ekmi�tir. SCO, g�ncel DS� s�n�flamas�nda �Derece I� olarak tan�mlansa da, �zellikle atipi-pleomorfizm ve mitotik aktivite sergileyen olgularda �nemli oranda erken n�ks g�r�lebilece�i g�z �n�nde bulundurulmal�d�r.

Anahtar Kelimeler: Adenohipofiz, i�si h�creli onkositom; imm�nhistokimya; sellar t�m�r.

Spindle Cell Oncocytoma of the Adenohypophysis: A Case with Atypical Histomorphological Features and Early Recurrence

Nil�fer Onak Kandemir¹, Banu Do�an G�n², Burak Bahad�r², �anser G�l³, �lker �z⁴, Nagehan �zdemir Bar��k⁵
¹Department of Pathology, Ankara Atat�rk Training and Research Hospital, Ankara, Turkey
²Department of Pathology, B�lent Ecevit University, Faculty of Medicine, Zonguldak, Turkey
³Department of Neurosurgery, B�lent Ecevit University Faculty of Medicine, Zonguldak, Turkey
⁴Department of Radiology, B�lent Ecevit University Faculty of Medicine, Zonguldak, Turkey
⁵Department of Pathology, Health Sciences University Faculty of Medicine, �stanbul, Turkey

Spindle cell oncocytoma (SCO) of the adenohypophysis is an extremely rare sellar-region tumor that creates clinicopathologically relevant problems in the differential diagnosis and difficulties in patient management due to the limited data available regarding its biological behavior. A sellar/suprasellar mass was detected and surgery was performed in a 61-year-old male admitted for impaired vision. The patient was re-operated on twice due to persistence of symptoms and an increase in tumor size at the third and sixth postoperative month. The histopathological examination revealed tumor cells with oncocytic cytoplasm and spindle-epithelioid morphology fascicles/layers/pseudoacinar structures. Neoplastic cells showed a positive immunoreactivity with vimentin, epithelial membrane antigen, galectin 3, thyroid transcription factor-1, and anti-mitochondrial antibodies, and a negative immunoreactivity with epithelial markers, pituitary hormones, and neuroendocrine markers. Compared with the first biopsy sample, the material obtained from recurrent lesions was histologically characterized by increased pleomorphism, atypia, and mitotic activity. Although SCO is defined as Grade I according to the current World Health Organization classification, the considerable risk of early recurrence should be taken into account, especially in cases with atypia-pleomorphism and increased mytotic activity.

Keywords: Adenohypophysis, sellar tumor; spindle cell oncocytoma.

Sorumlu Yazar: Nil�fer Onak Kandemir, T�rkiye
Makale Dili: �ngilizce

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