Presenter
Claire Coire
Authors
Claire I. Coire1, David G. Munoz2, Mihaly Kis3
1 Trillium Health Partners, Mississauga Hospital, and Laboratory Medicine and Pathobiology, University of Toronto, Toronto ON Canada.
2 Unity Health Toronto, St. Michael’s Hospital and Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON Canada
3 Trillium Health Partners, Mississauga Hospital and Division of Neurosurgery, University of Toronto, Toronto, ON Canada
Clinical Summary
A 44-year-old female referred to a neurosurgeon for management of a sellar and suprasellar mass causing mass effect on the optic chiasma. The patient reported frequent bitemporal headaches and some visual blurring. She did not appear acromegalic. She did not report change in her facial features, or increase in the size of her hands and feet. She endorsed excessive sweating and numerous skin tags. Her weight had been relatively stable. Endocrine evaluation had been normal other than slightly elevated IGF-1 levels.
The preoperative MRI imaging of the sella had shown an expansile bilobed enhancing mass centered in the sella and suprasellar cistern that measured 12 x 12 x 10 mm.
Discussion points
- Diagnosis
- What further immunostain(s) should be done in this case?
- What is the histogenesis of these lesions?
Reveal Diagnosis
Case of mixed gangliocytoma-somatotroph densely granulated and lactotroph sparsely granulated PitNET/adenoma
References
1. Diagnostic Pathology: Endocrine, Third Edition;646-649
2. WHO Classification of Tumours online: Endocrine and Neuroendocrine Tumours (5th ed.) //Pituitary tumours
//Posterior pituitary and hypothalamic neoplasms //Neuronal tumours //Gangliocytoma and mixed gangliocytoma-
PitNET/adenoma
3. Am J Surg Pathol 2017;41:586-595
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