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A case of ganglioneuroma arising in the pituitary fossa

1964; BMJ; Volume: 27; Issue: 3 Linguagem: Inglês

10.1136/jnnp.27.3.268

1468-330X

D. M. Robertson, R. F. Hetherington,

Glioma Diagnosis and Treatment

Primary tumours arising in neural tissue located in the sella turcica are infrequently encountered.The pars nervosa of the pituitary gland contains glial cells ('pituicytes'), generally thought to be modified astrocytes, and axons derived from theneurones ofthe supra-optic and paraventricular nuclei, but is devoid of neurones.The majority of reported neurohypophyseal tumours have been gliomas.Scothome (1955) described a piloid astrocytoma confined to the posterior lobe of the pituitary gland, and re- viewed several similar previously reported cases; since some of these had also involved hypothalamic structures their site of origin was open to question.The term 'infundibuloma' was proposed for gliomas of the neurohypophysis by Globus (1942).However, Russell and Rubinstein (1959) regarded these tumours as identical to pilocytic astrocytomas occurring elsewhere in the brain.Ganglioneuromas of the neurohypophysis would appear to be very much less common.One example, reported briefly by Benda (1927) and subsequently in greater detail by Casper (1933), was an incidental finding at necropsy in a woman, 72 years of age.The tumour, 6 x 11 mm., destroyed the posterior lobe of the pituitary gland but the anterior lobe was intact.Although the tumour projected above the level of the sella turcica, it was not attached to the brain; its relationship to the hypophyseal stalk was not determined.On histological examina- tion, the tumour was found to contain numerous large and small neurones, many of which were binucleate, and axons and glial elements.Occasional clusters of small, dense nuclei were observed, and thought to represent immature neural elements.A search of the recent literature has failed to reveal additional similar cases. CASE REPORTA.M., a 45-year-old housewife, was admitted to the Kingston General Hospital on 20 February 1963, for investigation of intractable headaches.These had been present for five years and had gradually increased in