Clinical features and endoscopic findings of granular cell tumor of the sellar region: A case report and review of the literature

  • Akari Kusakawa
    Departments of Neurosurgery, Ehime University School of Medicine, Shitsukawa, Toon, Ehime, Japan.
  • Akihiro Inoue
    Departments of Neurosurgery, Ehime University School of Medicine, Shitsukawa, Toon, Ehime, Japan.
  • Yawara Nakamura
    Departments of Neurosurgery, Ehime University School of Medicine, Shitsukawa, Toon, Ehime, Japan.
  • Naoya Nishida
    Departments of Otolaryngology, Ehime University School of Medicine, Shitsukawa, Toon, Ehime, Japan.
  • Mana Fukushima
    Division of Diagnostic Pathology, Ehime University School of Medicine, Shitsukawa, Toon, Ehime, Japan.
  • Hidenori Senba
    Departments of Lifestyle-related Medicine and Endocrinology, Ehime University School of Medicine, Shitsukawa, Toon, Ehime, Japan.
  • Satoshi Suehiro
    Departments of Neurosurgery, Ehime University School of Medicine, Shitsukawa, Toon, Ehime, Japan.
  • Shirabe Matsumoto
    Departments of Neurosurgery, Ehime University School of Medicine, Shitsukawa, Toon, Ehime, Japan.
  • Masahiro Nishikawa
    Departments of Neurosurgery, Ehime University School of Medicine, Shitsukawa, Toon, Ehime, Japan.
  • Saya Ozaki
    Departments of Neurosurgery, Ehime University School of Medicine, Shitsukawa, Toon, Ehime, Japan.
  • Seiji Shigekawa
    Departments of Neurosurgery, Ehime University School of Medicine, Shitsukawa, Toon, Ehime, Japan.
  • Hideaki Watanabe
    Departments of Neurosurgery, Ehime University School of Medicine, Shitsukawa, Toon, Ehime, Japan.
  • Bunzo Matsuura
    Departments of Lifestyle-related Medicine and Endocrinology, Ehime University School of Medicine, Shitsukawa, Toon, Ehime, Japan.
  • Riko Kitazawa
    Division of Diagnostic Pathology, Ehime University School of Medicine, Shitsukawa, Toon, Ehime, Japan.
  • Takeharu Kunieda
    Departments of Neurosurgery, Ehime University School of Medicine, Shitsukawa, Toon, Ehime, Japan.

説明

<jats:sec id="st1"> <jats:title>Background: </jats:title> <jats:p>Granular cell tumor (GCT) of the sellar region is a rare tumor of the sellar and suprasellar regions that originate from the neurohypophysis. This tumor is very difficult to differentiate from other pituitary neoplasms, such as pituitary adenoma, pituicytoma, and spindle cell oncocytoma. We report a rare case of GCT arising from the posterior pituitary of the sellar region and suggest a useful indicator for accurate diagnosis and pitfalls for surgical procedures.</jats:p> </jats:sec> <jats:sec id="st2"> <jats:title>Case Description: </jats:title> <jats:p>A 42-year-old woman was admitted to our hospital with bitemporal hemianopsia. Neuroimaging showed a large pituitary tumor in the sellar and suprasellar regions with a hypointense part on T2-weighted magnetic resonance imaging, and the enhanced anterior pituitary gland was displaced anteriorly. Laboratory findings showed mild hyperprolactinemia. Subtotal resection of the tumor was achieved using an endoscopic endonasal transsphenoidal approach. Histological findings showed round or polygonal cells with abundant granular eosinophilic cytoplasm staining strongly for thyroid transcription factor 1. The tumor was, therefore, diagnosed as a GCT of the sellar region, belonging to tumors of the posterior pituitary. After surgery, visual impairment and anterior pituitary function were improved. Follow-up neuroimaging after 1 year showed no signs of recurrence.</jats:p> </jats:sec> <jats:sec id="st3"> <jats:title>Conclusion: </jats:title> <jats:p>GCT of the sellar region is difficult to diagnose on routine neuroimaging. Therefore, accurate diagnosis requires careful identification of clinical signs, magnetic resonance imaging including hypointensity on T2-weighted imaging, and analysis of combined morphological and immunohistochemical studies.</jats:p> </jats:sec>

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