1 Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China;
2 Department of Neural Reconstruction, Beijing Neurosurgery Institute, Capital Medical University, Beijing 100050, China
Gangliocytoma combined with a pituitary adenoma: Reports of three cases and literature review
1 Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China;
2 Department of Neural Reconstruction, Beijing Neurosurgery Institute, Capital Medical University, Beijing 100050, China
摘要 Objectives: Sellar gangliocytomas are extremely rare. Since they present clinically and radiologically as pituitary adenomas, the preoperative diagnosis of these mixed tumors is very difficult. Here, we report three cases of gangliocytoma combined with pituitary adenoma and describe our findings. Methods: The clinical data of the three cases of gangliocytoma combined with pituitary adenoma have been retrospectively analyzed, and the published literature has also been reviewed. Results: All three patients underwent pure endonasal endoscopic surgery, and no recurrence was observed over a follow-up of at least 30 months. Growth hormone (GH)-hypersecreting adenoma and tumor calcification were detected in these mixed tumors. Conclusions: Pure endoscopic transnasal transsphenoidal surgery may be an effective way for the treatment of this kind of tumor. Gross total resection of the tumor is recommended. In addition, calcification with GH-hypersecretion may serve as a preoperative diagnostic clue for gangliocytoma in the sella turcica.
Abstract: Objectives: Sellar gangliocytomas are extremely rare. Since they present clinically and radiologically as pituitary adenomas, the preoperative diagnosis of these mixed tumors is very difficult. Here, we report three cases of gangliocytoma combined with pituitary adenoma and describe our findings. Methods: The clinical data of the three cases of gangliocytoma combined with pituitary adenoma have been retrospectively analyzed, and the published literature has also been reviewed. Results: All three patients underwent pure endonasal endoscopic surgery, and no recurrence was observed over a follow-up of at least 30 months. Growth hormone (GH)-hypersecreting adenoma and tumor calcification were detected in these mixed tumors. Conclusions: Pure endoscopic transnasal transsphenoidal surgery may be an effective way for the treatment of this kind of tumor. Gross total resection of the tumor is recommended. In addition, calcification with GH-hypersecretion may serve as a preoperative diagnostic clue for gangliocytoma in the sella turcica.
Zhenmin Wang, Peng Li, Qiangyi Zhou, Zhijun Yang, Pinan Liu. Gangliocytoma combined with a pituitary adenoma: Reports of three cases and literature review[J]. 临床转化神经科学, 2016, 2(3): 165-171.
Zhenmin Wang, Peng Li, Qiangyi Zhou, Zhijun Yang, Pinan Liu. Gangliocytoma combined with a pituitary adenoma: Reports of three cases and literature review. Translational Neuroscience and Clinics, 2016, 2(3): 165-171.
20161117195508 Figure 1 Case 1. The preoperative MRI (a-c) demonstrates an enlarged sella turcica containing an intrasellar mass with a suprasellar extension, showing high density on the CT scan (d). The postoperative MRI shows that the mass lesion was totally removed (e, f). Photomicrographs showing large, sometimes pyramid-shaped cells that are often multinucleated and undergoing atypical mitosis (g, HE, ×200), and positive expression of NSE (h, IHC, ×400). MRI: magnetic resonance imaging; CT: computed tomography; NSE: neuron specific enolase; IHC: immunohistochemistry
20161117195633 Table 1 The endocrine test results of the three cases
20161117195835 Figure 2 Case 2. The preoperative CT scan (a–c) and MRI (d–f) demonstrate an enlarged sella turcica containing an intrasellar calcified mass with a suprasellar extension, which was totally removed by surgery. Histopathological examination showing multinucleated tumor cells (g, HE, ×200) and NSE positive expression (h, IHC, ×400). MRI: magnetic resonance imaging; CT: computed tomography; NSE: neuron specific enolase; IHC: immunohistochemistry; HE: hematoxylin and eosin.
20161117195922 Figure 3 Case 3. A sellar lesion with calcification is observed in the preoperative MRI and CT (a–d), and postoperative MRI (e–f) shows that the lesion has been removed totally. Histopathological examination showing multinucleated tumor cells (g, HE, ×200) , NSE positive expression (h, IHC, ×400). MRI: magnetic resonance imaging; CT: computed tomography; NSE: neuron specific enolase; IHC: immunohistochemistry; HE: hematoxylin and eosin.
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2016, Vol. 2 
