Growth hormone-producing pituitary adenoma regrowing as pituitary adenoma with neuronal choristoma 14 years after tumor removal.
BACKGROUND
We report a case of an uncommon association of pituitary adenoma with neuronal choristoma that usually is diagnosed at initial surgery.


METHODS
A 50-year-old woman with acromegaly and bitemporal hemianopsia underwent removal of a pituitary adenoma via the transsphenoidal approach. Histologic examination of the first surgical specimen demonstrated only adenoma, which was eosinophilic and expressed growth hormone. Fourteen years later, bitemporal hemianopsia recurred, and magnetic resonance imaging revealed regrowth of the residual tumor.


CONCLUSIONS
The patient underwent removal of the regrown tumor via the transsphenoidal approach. Histologic examination of the second surgical specimen revealed gangliocytoma and a small component of pituitary adenoma.


CONCLUSIONS
The present case report supports the theory that pituitary adenoma with neuronal choristoma might represent the result of neuronal differentiation from pituitary adenoma.
Department of Neurosurgery, Iwate Medical University, Morioka, Japan.
Yuichi
Y
Sato
Tsukasa
T
Wada
Yasumasa
Y
Nishikawa
Kenji
K
Yoshida
Akira
A
Kurose
Akira
A
Ogawa
Kuniaki
K
Ogasawara
D000172:Acromegaly / Q000209:etiology; D000236:Adenoma / Q000473:pathology* / Q000601:surgery; D002828:Choristoma / Q000473:pathology* / Q000601:surgery; D005260:Female; D005729:Ganglioneuroma / Q000473:pathology / Q000601:surgery; D049912:Growth Hormone-Secreting Pituitary Adenoma / Q000473:pathology* / Q000601:surgery; D006423:Hemianopsia / Q000209:etiology; D019382:Human Growth Hormone / Q000096:biosynthesis / Q000378:metabolism; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007150:Immunohistochemistry; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D018365:Neoplasm, Residual; D019635:Neurosurgical Procedures / Q000379:methods; D012008:Recurrence
D019382:Human Growth Hormone