Mixed pituitary adenoma and gangliocytoma associated with acromegaly--case report.
A gangliocytoma in the sellar region is very rare. We report a case of an intrasellar gangliocytoma complicated by pituitary adenoma presenting with acromegaly. A 52-year-old female was admitted to our hospital with headache, mild acromegaly, and bitemporal hemianopsia, and endocrinological study found a high serum level of growth hormone (GH). A computed tomographic scan revealed a tumor in the sellar region, which was almost totally removed by trans-sphenoidal surgery. Histological examination of the resected specimen showed diffuse, chromophobe-type pituitary adenoma, partially containing cholesterin clefts. Areas of clusters of dysmorphic neurons, adjacent to or mixed with pituitary adenoma, were diagnosed as gangliocytoma. The immunohistochemical examination showed GH-releasing hormone (GRH)-positive dysmorphic neurons and GH-positive pituitary adenoma. We consider that the trophic effect of GRH secreted by the neurons of GRH-producing intrasellar gangliocytoma probably caused the GH-producing pituitary adenoma.
Asada
H
H
Department of Neurosurgery, School of Medicine, Keio University, Tokyo.
Otani
M
M
Furuhata
S
S
Inoue
H
H
Toya
S
S
Ogawa
Y
Y
D000172:Acromegaly / Q000209:etiology* / Q000473:pathology; D000236:Adenoma / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D005729:Ganglioneuroma / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D010911:Pituitary Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D014057:Tomography, X-Ray Computed