OBJECTIVE: To present a case describing an incidentally discovered pituitary mass that was found to be a collision tumor containing 2 distinct histologic cell types: (1) a growth hormone (GH)-secreting pituitary adenoma, and (2) a gangliocytoma. METHODS: Sellar gangliocytomas are very rare benign neuroblastic tumors that originate from the posterior pituitary. The majority are associated with pituitary adenomas. The co-existence of these 2 morphologically distinct tumors is known as a collision tumor, a rare disease entity of which the pathogenesis is not well understood. We present a case of a woman with an incidentally discovered pituitary mass that was found to be a collision tumor. RESULTS: A 44-year-old woman presented with an incidentally discovered pituitary mass and was found to have elevated insulin-like growth factor 1 (IGF-1) levels. The patient underwent endoscopic transsphenoidal excision of the pituitary mass. Histopathology of the tumor revealed a mixed pituitary adenoma that stained for GH and prolactin, and a gangliocytoma. Postoperatively, the patient developed temporary central adrenal insufficiency and permanent diabetes insipidus. Postoperative lab studies revealed a normal IGF-1 level, and a magnetic resonance imaging scan showed no residual or recurrent tumor. CONCLUSION: While sellar gangliocytoma is a rare lesion, when it is present, a co-existing pituitary adenoma should also be suspected. Further investigation should be done to determine the pathophysiology of these collision tumors, which could be beneficial in guiding diagnosis and treatment.
OBJECTIVE: To present a case describing an incidentally discovered pituitary mass that was found to be a collision tumor containing 2 distinct histologic cell types: (1) a growth hormone (GH)-secreting pituitary adenoma, and (2) a gangliocytoma. METHODS: Sellar gangliocytomas are very rare benign neuroblastic tumors that originate from the posterior pituitary. The majority are associated with pituitary adenomas. The co-existence of these 2 morphologically distinct tumors is known as a collision tumor, a rare disease entity of which the pathogenesis is not well understood. We present a case of a woman with an incidentally discovered pituitary mass that was found to be a collision tumor. RESULTS: A 44-year-old woman presented with an incidentally discovered pituitary mass and was found to have elevated insulin-like growth factor 1 (IGF-1) levels. The patient underwent endoscopic transsphenoidal excision of the pituitary mass. Histopathology of the tumor revealed a mixed pituitary adenoma that stained for GH and prolactin, and a gangliocytoma. Postoperatively, the patient developed temporary central adrenal insufficiency and permanent diabetes insipidus. Postoperative lab studies revealed a normal IGF-1 level, and a magnetic resonance imaging scan showed no residual or recurrent tumor. CONCLUSION: While sellar gangliocytoma is a rare lesion, when it is present, a co-existing pituitary adenoma should also be suspected. Further investigation should be done to determine the pathophysiology of these collision tumors, which could be beneficial in guiding diagnosis and treatment.
Authors: S L Asa; B W Scheithauer; J M Bilbao; E Horvath; N Ryan; K Kovacs; R V Randall; E R Laws; W Singer; J A Linfoot Journal: J Clin Endocrinol Metab Date: 1984-05 Impact factor: 5.958
Authors: Matthew J Shepard; Mohamed A Elzoghby; Daffer Ghanim; M Beatriz S Lopes; John A Jane Journal: World Neurosurg Date: 2017-09-05 Impact factor: 2.104
Authors: Maria Koutourousiou; George Kontogeorgos; Pieter Wesseling; Andre J Grotenhuis; Andreas Seretis Journal: Pituitary Date: 2009-06-24 Impact factor: 4.107