Granular cell tumor (GCT) mimicking a nonsecreting anterior pituitary adenoma

Abstract

A 33-year-old male with right eye amaurosis and panhypopituitarism previously submitted to surgery and radiotherapy was admitted with a presumptive recurrence of a nonsecreting pituitary macroadenoma (the first diagnosis, in another service). Magnetic Resonance Imaging (MRI) confirmed an expansive solid isointense lesion in the posterior region of the sella with suprasellar component (Figure 1). After a new surgery, histological revealed granular cell tumor (GCT) (Figure 2).GCT of the CNS is rare 1.This report emphasizes the importance of this differential diagnosis in preoperatory for solid lesions with suprasellar component, homogeneous enhancement, and hyperattenuated on CT since they are more vascular and tend to bleed more than macroadenomas In the first surgical sample, the lesion showed morphological features essentially similar to those observed in the second specimen. Cells with cytoplasmic granules (A; Hematoxylin-eosin), which do not contain glycogen (B; Periodic Acid-Schiff with diastase digestion) and correspond to lysossomes (C: electron microscopy). In the first surgical sample, the lesion showed morphological features essentially similar to those observed in the second specimen.

Granular Cell Pituitary Tumor in a Patient with Multiple Endocrine Neoplasia-1

“…Separately, granular cell tumors (GCTs) of the sellar/suprasellar region are an exceedingly rare clinical entity with less than 100 reported cases in the literature [2-4]. These slow-growing, often incidental and asymptomatic lesions are difficult to diagnose and may mimic pituitary adenoma [5], Rathke cleft cyst [6], or other sellar/supra-sellar pathology [7]. There is no known association of GCTs with MEN-1 or any other familial syndrome.…”