Ganglioglioma of the neurohypophysis with secretion of vasopressin

Abstract

A patient with a ganglioglioma of the neurohypophysis developed the syndrome of inappropriate antidiuretic hormone secretion (SIADH). We present the case and describe its microscopic and ultrastructural features. Malignant neoplasms were thought to be the main cause of ectopic production of vasopressin. Head trauma, infection, or drugs, however, can also induce hypersecretion of vasopressin. Mechanical compression of the pituitary stalk can lead to an excessive antidiuretic hormone (ADH) release by affecting the inhibitory system. Primary neuroendocrine tumors of the hypothalamic-neurohypophyseal system are extremely rare. We demonstrate the presence of vasopressin in the tumor cells by immunocytochemistry. This represents the first case of SIADH caused by a tumor of the neurohypophysis.

Ganglion cell tumours in the sella turcica in close morphological connection with pituitary adenomas

“…Occasionally, pure ganglion cell tumours are themselves hormonally active [35]. An unique case of ganglioglioma of the neurohypophysis associated with syndrome of inappropriate antidiuretic hormone secretion (SIADH) has been reported [14].…”

Gliomas in the Sellar Turcica Region: A Retrospective Study Including Adult Cases and Comparison with Craniopharyngioma

“…This study included one small cell glioblastoma [11,12,13,14,15,16,17], one ganglioglioma [18,19,] and one pituicytoma [3,4], which have all rarely been reported in the literature. Small cell glioblastoma is a new pattern of glioblastoma introduced in the 2007 classification, which consists of uniform and highly proliferative small glioma cells [20].…”

Ganglioglioma of the Neurohypophysis

“…Etiologic considerations included: (a) an ectopia, possibly the result of a migration abnormality, (b) maturation of neuroblasts presumed to occur in the embryonic neurohypophysis, and lastly, (c) neuronal "transdifferentiation" from the ACTH-positive cells of basophil invasion. A second published neuronal lesion of the neurohypophysis was a ganglioglioma like our own [6]. Its key feature was its occurrence in association with the syndrome of inappropriate antidiuretic hormone (ADH) secretion and the finding of vasopressin within its neurons.…”

“…A number of observations lend insight into this mechanism and support its occurrence, including: (a) lack of pituitary hyperplasia as an element of PANCH [21], (b) the almost exclusive GH-producing adenoma subtype involved, (c) transition to adenoma cells being minute and multifocal in some adenomas, and (d) the fact that a subset of pituitary adenomas of acromegaly produce growth hormone-releasing hormone [22], its stimulatory effect apparently being autocrine. In contrast, the posterior pituitary is rarely affected by neuronal lesions; only four cases have been reported in humans [5,6,10,23]. One previous example of ectopic ganglion cells, perhaps an example of a gangliocytoma was reported by Horvath et al [5].…”

“…Neuronal lesions are exceedingly rare. They include one report of neuronal ectopia [5], a lesion less cellular and tumefactive than gangliocytoma, and one example of a symptomatic, vasopressin (antidiuretic hormone)-producing ganglioglioma associated with syndrome of inappropriate antidiuretic hormone secretion (SIADH) [6]. Herein, we report a nonvasopressin-producing neurohypophysial ganglion cell tumor, an incidental autopsy finding.…”