An intrasellar mixed gangliocytoma-adenoma including ependymal component, and review of the literature.

A rare case of intrasellar mixed gangliocytoma–adenoma including ependymal component, which presented clinically with acromegaly and menstrual disorder, is described here. The tumour was totally removed via trans-sphenoidal surgery. A histological examination of the resected specimen showed that the tumour was composed of ganglion cells, adenomatous cells and ependymal cells. Most intrasellar gangliocytomas are composed of two components: adenomatous cells and ganglion cells. In this case, in addition to mixed adenomatous and ganglion cells, focal ependymal cells forming small cysts were found. Based on these histopathological findings, it was inferred that stem cells existed in the pituitary gland during embryonic development. The stem cells were able to differentiate into three directions: ganglion cells, adenomatous cells and ependymal cells, and as a result an intrasellar mixed gangliocyto-adenoma including ependymal component developed.