COMBINED SELLAR GANGLIOCYTOMA AND PITUITARY-ADENOMA IN ACROMEGALY OR CUSHINGS-DISEASE - A REPORT OF 3 CASES

Three cases of a composite sellar tumour composed of a gangliocytoma a nd an adenoma are presented. Two patients who showed acromegaly and hy perprolactinaemia had a gangliocytoma and a growth hormone (GH)-prolac tin cell adenoma in close proximity. The gangliocytoma contained growt h hormone-releasing hormone (GHRH) by immunohistochemistry. At the ele ctron microscopical level, the gangliocytoma was characterized by nume rous synaptic vesicles. The third patient, a child with Cushing's dise ase, presented a corticotropin-releasing hormone (CRH)-positive gangli ocytoma in close contact with an adrenocorticotropic hormone (ACTH) se creting adenoma, the latter a typical densely granulated ACTH cell ade noma. Ultrastructurally, the gangliocytoma revealed synaptic vesicles and sparse secretory granules. The results suggest that gangliocytomas may promote the development of pituitary adenomas by hypersecretion o f releasing hormones. Whereas 20 cases of sellar GHRH producing gangli ocytomas in acromegaly are reported in the literature, the combination of a CRH-positive gangliocytoma and an ACTH cell adenoma in Cushing's disease is apparently the first case.