Pituicytoma in the UAE: A Rare Sellar Tumor and the First Reported National Case

Background: Pituicytoma is an exceptionally rare low-grade glioma of the sellar and suprasellar region, derived from the specialized glial cells of the posterior pituitary and infundibulum. Since its first description in 1994, only a limited number of cases have been reported worldwide. Clinically and radiologically, pituicytomas often mimic pituitary adenomas or other sellar neoplasms, making preoperative diagnosis challenging. Histopathology and immunohistochemistry remain central for definitive diagnosis, with thyroid transcription factor-1 (TTF-1) serving as the most consistent marker. The rarity of the tumor, together with its nonspecific presentation, contributes to frequent misdiagnosis and delayed recognition. We report the first case of pituicytoma diagnosed in a United Arab Emirates (UAE) national. Case Description: A 52-year-old Emirati male presented with a two-day history of severe persistent headache and recurrent vomiting, accompanied by mild blurring of vision. He also reported longstanding symptoms of hypogonadism and intermittent headache episodes over several years. Emergency CT brain revealed a suprasellar mass, and MRI demonstrated a well-circumscribed sellar and suprasellar lesion measuring 20 × 15 mm, compressing and elevating the optic chiasm, radiologically suggestive of pituitary macroadenoma ([ Fig. 1 ]). Neuro-ophthalmological evaluation showed visual acuity of 6/6 bilaterally, with a left-sided temporal visual field defect. Endocrine assessment revealed secondary adrenal insufficiency and central hypothyroidism, along with hypogonadotropic hypogonadism. Replacement therapy with hydrocortisone and levothyroxine was initiated preoperatively. The patient underwent an endoscopic endonasal transsphenoidal resection of the mass performed jointly by the neurosurgery and otolaryngology teams. Intraoperatively, the lesion was highly vascular, necessitating meticulous hemostasis. Gross total resection was achieved without surgical complications. Histopathological examination revealed a spindle-cell neoplasm arranged in fascicles, with cells strongly and diffusely positive for TTF-1, and negative for cytokeratin, EMA, chromogranin, and GFAP. The Ki-67 proliferative index was