Ganglioglioma of the adenohypophysis mimicking pituitary adenoma: A case report and review of the literature.
Ganglioglioma of the adenohypophysis mimicking pituitary adenoma: A case report and review of the literature.
复制标题
类似垂体腺瘤的腺垂体神经节胶质瘤：一例报告并文献复习
DOI：
10.1097/md.0000000000011583
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发表时间：
2018-07
期刊：
影响因子：
1.6
通讯作者：
Wang Y
中科院分区：
文献类型：
--
作者：
Hong Y;Fang Y;Wu Q;Zhang J;Wang Y
神经节细胞胶质瘤是一种良性肿瘤，多见于30岁以上的患者。最常累及的是颞叶。到目前为止，仅报道了3例垂体神经节细胞胶质瘤，均局限于神经垂体。在这里，我们是第一个报告的腺垂体节细胞胶质瘤。一位43岁女性患者因慢性头痛被转诊至本院。磁共振成像(MRI)显示为垂体腺瘤。采用鼻内窥镜下经鼻蝶入路手术。肿瘤血供丰富，质地坚韧，仅行次全切除。病理分析显示，由发育不良的神经节细胞和肿瘤胶质细胞组成的腺垂体肿瘤与非特异性的垂体细胞增生相撞。免疫组织化学显示突触素、胶质纤维酸性蛋白和CD34染色阳性。结果与神经节胶质瘤的诊断一致。术后除发生脑脊液鼻漏外，其余均恢复良好，并经腰椎引流控制。6个月后，核磁共振没有显示任何进展的迹象。根据我们病例的研究结果，应将神经节细胞胶质瘤视为鞍区肿块的鉴别诊断。此外，垂体节细胞胶质瘤的理想治疗策略尚不清楚，因此，需要更多的病例和长期的随访来丰富我们对这种罕见的颅内病变的诊断、治疗和预后的知识。
Ganglioglioma is a generally benign tumor, mostly occurring in patients <30 years old. Temporal lobe is most frequently involved. Up to now, only 3 cases were reported of ganglioglioma in the pituitary gland, all being confined to the neurohypophysis. Here, we are the first to report an adenohypophysis ganglioglioma. A 43-year-old woman presented with chronic headache was referred to our hospital. Magnetic resonance imaging (MRI) indicated pituitary adenoma. Endoscopic transnasal transsphenoidal surgery was performed. The tumor was rich in blood supply, with tough texture, therefore only subtotal resection was conducted. Pathology analysis revealed an adenohypophysial tumor composed of dysplastic ganglion cells and neoplastic glial cells collided with nonspecific hyperplasia of pituitary cells. Immunohistochemistry revealed positive staining of synaptophysin, glial-fibrillary acidic protein, and CD34. The results were consistent with the diagnosis of ganglioglioma. After the surgery the patient recovered well except developing cerebrospinal fluid rhinorrhea, which was controlled by lumbar drainage. MRI 6 months later did not show any sign of progression. According to the findings of our case, concerns should be raised considering ganglioglioma as a differential diagnosis of mass located in the sellar region. Furthermore, an ideal management strategy for pituitary ganglioglioma is not known; therefore, more cases and long-term follow-up are needed to enrich our knowledge of the diagnosis, treatment, and prognosis of this rare intracranial lesion.