Brain Tumor Res Treat.  2015 Apr;3(1):60-63. 10.14791/btrt.2015.3.1.60.

Granular Cell Tumor in the Pituitary Stalk: A Case Report

Affiliations
  • 1Department of Neurosurgery, Ewha Womans University Mokdong Hospital, Seoul, Korea. drekseo@ewha.ac.kr

Abstract

Granular cell tumors (GCTs) have been reported in various tissues, especially the skin and subcutaneous soft tissue of the head and neck. We report a 60-year-old man who presented with intermittent headache and dizziness for 3 months, but no other neurological symptoms. Magnetic resonance imaging (MRI) showed the presence of a mass in the pituitary stalk, and contrast-enhanced MRI showed nodular enhancement in this region. The lesion was completely excised microscopically via a frontotemporal (pterional) approach. On pathological examination, a final diagnosis of a typical GCT was made.

Keyword

Granular cell tumor; Pituitary neoplasms

MeSH Terms

Diagnosis
Dizziness
Granular Cell Tumor*
Head
Headache
Humans
Magnetic Resonance Imaging
Middle Aged
Neck
Pituitary Gland*
Pituitary Neoplasms
Skin

Figure

  • Fig. 1 Preoperative magnetic resonance imaging findings. A: A preoperative T1-weighted gadolinium-enhanced axial image shows a homogenous enhanced round mass (white arrow). B: A T1-weighted gadolinium-enhanced coronal image shows the pituitary stalk (white arrow). C: An anterior view of image B shows a round mass (white arrowhead). D: A T2-weighted axial image shows a mass (arrow) with low signal intensity.

  • Fig. 2 Surgical findings. A: The tumor (asterisk) is round, and adjacent to the pituitary stalk. B: After tumor excision, the pituitary stalk (arrow) appears thinned, but remains intact.

  • Fig. 3 Histopathologic findings. A: The tumor consists of large polygonal cells with ample granular cytoplasm and small, oval, eccentric nuclei (hematoxylin and eosin; original magnification ×100). B: The tumor shows dense fibrocollagenous tissue admixed with granular cell nests. Multifocal lymphocytic infiltration can also be observed (original magnification ×100). C: Immunostaining for S-100 shows diffuse weak to strong positivity (original magnification ×100).

  • Fig. 4 Postoperative magnetic resonance imaging findings. A postoperative T1-weighted gadolinium-enhanced coronal image shows resection of the tumor adjacent to the pituitary stalk. The pituitary stalk remains intact.


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