title: Intrasellar pituitary gangliocyto-adenoma presenting with acromegaly: case report.
abstract: OBJECTIVE
  A gangliocytoma in the sellar region is extremely rare. We describe a rare case of intraseller gangliocytoma coexisting with a growth hormone-producing pituitary adenoma, which presented with acromegaly.
  
  
  METHODS
  A 64-year-old woman was admitted to our hospital with headache and acromegaly. Endocrinological studies revealed an elevated serum level of growth hormone (GH). Magnetic resonance imaging showed a tumor at the intrasellar and suprasellar regions. The tumor was totally removed via a transsphenoidal approach.
  
  
  RESULTS
  A histological examination of the resected specimen showed areas of ganglionic cells and adenomatous cells. Immunohistochemical examination demonstrated GH-releasing hormone-positive ganglionic cells and GH-positive pituitary adenoma.
  
  
  CONCLUSIONS
  Based on these immunohistochemical findings, we hypothesized that the intrasellar gangliocytoma promoted the growth of the pituitary adenoma, which had been transformed from a region of pituitary hyperplasia by chronic overstimulation from excess GH-releasing hormone produced by the intrasellar gangliocytoma.
authors.affiliation: Department of Neurosurgery, Kobe University, School of Medicine, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Morikawa
authors.forename: N
authors.initials: N
authors.lastname: Tamaki
authors.forename: T
authors.initials: T
authors.lastname: Kokunai
authors.forename: Y
authors.initials: Y
authors.lastname: Imai
mesh_terms: D000172:Acromegaly / Q000473:pathology / Q000601:surgery*; D014408:Biomarkers, Tumor / Q000032:analysis; D005260:Female; D005729:Ganglioneuroma / Q000473:pathology / Q000601:surgery*; D019382:Human Growth Hormone / Q000032:analysis; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009384:Paraneoplastic Endocrine Syndromes / Q000473:pathology / Q000601:surgery*; D010902:Pituitary Gland / Q000473:pathology; D010911:Pituitary Neoplasms / Q000473:pathology / Q000601:surgery*
chemical_list: D014408:Biomarkers, Tumor; D019382:Human Growth Hormone