Vasculogenic mimicry in clinically non-functioning pituitary Adenomas: a histologic study

Joseph Di Michele, Fabio Rotondo, Kalman Kovacs, Luis V. Syro, George M. Yousef, Michael D. Cusimano, Antonio Di Ieva

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    7 Citations (Scopus)


    The term "vasculogenic mimicry" (VM) refers to the phenomenon in which vascular-like channels, which are not lined by endothelial cells, are formed in tumors. Since its discovery in 1999, it has been observed in several tumor types and is proposed to provide blood perfusion to tumors in absence of co-apted or neo-angiogenic blood vessels. Pituitary tumors are generally slow growing, benign adenomas which are less vascularized than the normal pituitary gland. To date, VM in pituitary adenomas has not been described. In this histological study, we assessed the presence of VM in a series of surgically resected clinically non-functioning pituitary adenomas (NFPAs) using CD34 and Periodic Acid-Schiff (PAS) double staining. To identify VM, slides were assessed for the presence of CD34-negative and PAS-positive channels indicating that they were not lined by endothelial cells. The histological staining pattern suggestive of VM was noted in 22/49 (44.9%) of the specimens studied. VM was observed in both recurring and non-recurring NFPAs. The incidence of VM present varied from case to case and within groups. There was no association between the presence of VM and gender, tumor size, Ki-67 index, recurrence or cavernous sinus invasion. VM was not noted in cases of non-tumorous pituitaries. Our findings suggest the existence of a complementary perfusion system in pituitary adenomas, implying potential clinical implications with respect to response to therapy and clinical course. Further research is warranted to confirm the presence of VM in pituitary adenomas to elucidate its clinical relevance in patients diagnosed with a pituitary adenoma.

    Original languageEnglish
    Pages (from-to)803-809
    Number of pages7
    JournalPathology and Oncology Research
    Issue number4
    Early online date13 Jan 2017
    Publication statusPublished - Oct 2017


    • biomarkers
    • pathology
    • pituitary adenoma
    • microvascularity
    • vasculogenic mimicry
    • Pathology
    • Microvascularity
    • Pituitary adenoma
    • Biomarkers
    • Vasculogenic mimicry


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