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Welcome to the April, 2013 edition of SciEP newsletter, providing monthly summaries of articles on science & education related topics of interest to scientist and professionals. The mission of our journals is to provide an open access forum for publishing new findings on issues pertinent to scientific and academic field. We also invite you to submit original research papers, review articles, short reports, or case studies are considered for publication in our Multidisciplinary Journals.

American Journal of Public Health Research
DOI: 10.12691/ajphr-1-1-3

The Implementation of a Tele-Homecare System with Service Oriented Architecture and HL7 Message Transmission Standard
Ching-Sung Wang

American Journal of Medical and Biological Research
DOI: 10.12691/ajmbr-1-1-2

The Influence of Ethanol on Pyruvate Kinases Activity in Vivo, in Vitro, in Silico
Lelevich Sergey Vladimirovich, Khrustalev Vladislav Victorovich, Barkovsky Eugene Victorovich, Shedogubova Tatyana Aleksandrovna

American Journal of Medical Sciences and Medicine
DOI: 10.12691/ajmsm-1-1-1

Clinical and Histological Features in Wegener Granulomatosis
Li Cavoli Gioacchino, Passantino Rita, Bono Luisa, Tortorici Calogera, Ferrantelli Angelo, Giammarresi Carlo, Rotolo Ugo

American Journal of Infectious Diseases and Microbiology
DOI: 10.12691/ajidm-1-1-2

The Curse of Lymphatic Filariasis: Would the Continual Use of Diethylcarbamazine Eliminate this Scourge in Papua New Guinea?
Anne Lanham, Lillian Mwanri

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American Journal of Medical and Biological Research
American Journal of Pharmacological Sciences
American Journal of Clinical Medicine Research
American Journal of Nursing Research
American Journal of Cancer Prevention
American Journal of Medicine Studies
American Journal of Infectious Diseases and Microbiology
American Journal of Cardiovascular Disease Research
American Journal of Biomedical Research
American Journal of Mechanical Engineering
American Journal of Microbiological Research
Journal of Preventive Medicine
American Journal of Food and Nutrition
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Pituitary Stalk Ganglioglioma an Uncommon Entity: A Case Report

Ali Al Mashani, Neeraj Salhotra*, Mohammad Hadad, Mohammad Hashim, Bashar Al Tunbi, Tariq Al Saadi

Department of Neurosurgery Khoula Hospital, Muscat

Abstract: Ganglioglioma is a well known entity in neurosurgery but its presentation in pituitary stalk is seen uncommonly. We present here a 35 year old lady with complaints of decreased vision, amenorrhea and headache. Examination revealed bitemporal heminopia. MRI confirmed a pituitary stalk lesion with optic tract compression. A pterional craniotomy was done and tumor was excised. Histopathology revealed it to be ganglioglioma WHO grade I. Patient is doing well under follow up with endocrinology.

Keywords: pituitary stalk ganglioglioma

Received October 01, 2018; Revised November 20, 2018; Accepted December 18, 2018

Citation: Ali Al Mashani, Neeraj Salhotra, Mohammad Hadad, Mohammad Hashim, Bashar Al Tunbi, Tariq Al Saadi, Pituitary Stalk Ganglioglioma an Uncommon Entity: A Case Report. American Journal of Medical Case Reports, 6 (11). 228-229. January 2018. doi:10.12691/ajmcr-6-11-4

1. Introduction

Ganglioglioma is a low grade tumor seen commonly in superatentorial compartment. Most commonly seen in young population. Seizures are a common presentation. But pituitary stalk involvement alone is rarely seen. We herewith present a young lady with pituitary stalk ganglioglioma.

2. Materials and Methods

This 35 year old lady presented in our hospital with secondary amenorrhea, headache and decreased vision. Examination revealed bitemporal heminopia. Lab revealed high prolactin going with stalk effect. Patient underwent a CT and followed by an MRI brain. Imaging revealed a small rounded lesion in the pituitary stalk with mild contrast enhancement. It was causing adjoining optic pathways compression. Pituitary hypophisitis was kept high a possibility and neoplasm less likely. Figure 1 and Figure 2 reveal the images.

Figure 1. Pre and post operative coronal images of the pituitary stalk ganglioglioma

Figure 2. Pre and post operative sagittal images of the pituitary stalk ganglioglioma

Figure 3. Pitutary stalk ganlgioglioma intraoperative picture

Figure 4. Lesion being excised

Figure 5. After excision of lesion from opticocatotid cisterns

3. Results

The patient was explained in detail the type of lesion, type of possibilities, risks and benefits of surgery and once patient and family was on board patient underwent a right pterional craniotomy and via carotico optic and interchiasmatic approach a piece meal microscopic excision of greyish soft moderately vascular lesion was done safeguarding the surrounding structures.

Postoperative period was uneventful. After 1day stay in ICU was shifted to ward once postoperative scan was satisfactory. Patient was discharged home with advice to follow with endocrine department. Histopathology to our surprise revealed lesion to be ganglioglioma as per HPE number H1804766.

Patient was followed in OPD with a MRI as per Figure 3. Patient is planned for a yearly follow up with MRI.

4. Discussion

In 1998 Fehn M reported a case of ganglioglioma in neurohypophysis with vasopresin secretion [1]. In 2008 Scheithauer BW described in detail the pathophysiology of the ganglioglioma in neurohypophysis with management of their case [2]. In 2018 Hong Y descibed another case of ganglioglioma of adenohypophysis which was mimicking as pitutary adenoma but histopathology confirmed the diagnosis [3]. Ganglioglioma are also reported in other uncommon sites like in 1998 Faillot T reported a ganglioglioma in pineal region [4]. Other uncommon tumour in infundibulum is granular cell tumour as reported by Polasek JB in 1998 [5]. In 2000 Horvath E descibed in detail the presence of ganglion cells in in posterior pitutary is either by ectopia or transdifferentiation [6].

5. Conclusion

As per literature review cited above pitutary stalk ganglioglioma is an uncommon entity. Our patient happens to be among them. As patient was symptomatic in view of location excision was required. Perioperative period was uneventful. Thus a infrequently seen entity was managed in most appropriate manner.

References

[1]   | Exp Clin Endocrinol Diabetes. 1998; 106(5): 425-30. Ganglioglioma of the neurohypophysis with secretion of vasopressin. Fehn M, Lohmann F, Lüdecke DK, Rudorff KH, Saeger W.
[2]   | Endocr Pathol. 2008 Summer; 19(2): 112-6. Ganglioglioma of the neurohypophysis. Scheithauer BW, Silva AI, Parisi JE, Kovacs K, Horvath E.
[3]   | Medicine (Baltimore). 2018 Jul; 97(30): e11583. Ganglioglioma of the adenohypophysis mimicking pituitary adenoma: A case report and review of the literature. Hong Y, Fang Y, Wu Q, Zhang J, Wang Y.
[4]   | Surg Neurol. 1998 Jan; 49(1): 104-7; discussion 107-8. Ganglioglioma of the pineal region: case report and review of the literature. Faillot T, Sichez JP, Capelle L, Kujas M, Fohanno D.
[5]   | J Neurooncol. 2018 Aug 23. [Epub ahead of print] Granular cell tumor of the infundibulum: a systematic review of MR-radiography, pathology, and clinical findings. Polasek JB, Laviv Y, Nigim F, Rojas R, Anderson M, Varma H, Kasper EM.
[6]   | Acta Neuropathol. 2000 Jul; 100(1): 106-10. Ganglion cells in the posterior pituitary: result of ectopia or transdifferentiation? Horvath E, Kovacs K, Tran A, Scheithauer BW.