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Collision lesions of the sella: co-existence of craniopharyngioma with gonadotroph adenoma and of Rathke’s cleft cyst with corticotroph adenoma

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Abstract

Collision lesions of the sellar region are relatively uncommon. Most contributions include a pituitary adenoma or a cyst/cystic tumor, particularly a Rathke cleft cyst. The association of craniopharyngioma with an adenoma is particularly rare. Among reported cases, some have included secondary prolactin cell hyperplasia due to pituitary stalk section effect. Herein, we report two collision lesions, including a gonadotroph adenoma with adamantinomatous craniopharyngioma and a corticotroph adenoma with Rathke’s cleft cyst. Clinicopathologic correlation and a review of the literature are undertaken.

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References

  1. Bunin GR, Surawicz TS, Witman PA, Preston-Martin S, Davis F, Bruner JM (1998) The descriptive epidemiology of craniopharyngioma. J Neurosurg 89:547–551

    Article  PubMed  CAS  Google Scholar 

  2. Parisi JE, Mena H (1993) Nonglial tumours. In: Nelson JS, Parisi JE, Schochet SS (eds) Principles and Practice of Neuropathology. Mosby, St. Louis, pp 203–266

    Google Scholar 

  3. Petito CK, DeGirolami U, Earle KM (1976) Craniopharyngiomas: a clinical and pathological review. Cancer 37:1944–1952

    Article  PubMed  CAS  Google Scholar 

  4. Harwood-Nash DC (1994) Neuroimaging of childhood craniopharyngioma. Pediatr Neurosurg 21Suppl 1:2–10

    Article  PubMed  Google Scholar 

  5. Karavitaki N, Brufani C, Warner JT, Adams CB, Richards P, Ansorge O, Shine B, Turner HE, Wass JA (2005) Craniopharyngiomas in children and adults: systematic analysis of 121 cases with long-term follow-up. Clin Endocrinol (Oxf) 62:397–409

    Article  CAS  Google Scholar 

  6. Goldberg GM, Eshbaugh DE (1960) Squamous cell nests of the pituitary gland as related to the origin of craniopharyngiomas. A study of their presence in the newborn and infants up to age four. Arch Pathol 70:293–299

    PubMed  CAS  Google Scholar 

  7. Hunter IJ (1955) Squamous metaplasia of cells of the anterior pituitary gland. J Pathol Bacteriol 69:141–145

    Article  PubMed  CAS  Google Scholar 

  8. Asa SL, Kovacs K, Bilbao JM (1983) The pars tuberalis of the human pituitary. A histologic, immunohistochemical, ultrastructural and immunoelectron microscopic analysis. Virchows Arch A Pathol Anat Histopathol 399:49–59

    Article  PubMed  CAS  Google Scholar 

  9. Duff JM, Meyer FB, Illstrup DM, Laws ER Jr, Schleck CD, Scheithauer BW (2000) Long-term outcomes for surgically resected craniopharyngiomas. Neurosurgery 46:291–305

    Article  Google Scholar 

  10. DeVile CJ (2002) Craniopharyngioma. In: Wass JAH, Shalet SM (eds) Oxford Textbook of Endocrinology and Diabetes. Oxford University Press, Oxford, pp 218–225

    Google Scholar 

  11. Sano K (1969) [Pituitary adenoma and craniopharyngioma]. No To Shinkei 21:1326–1329

  12. Prabhakar V, Rao BD, Subramanyam MV (1971) Pituitary adenoma associated with craniopharyngioma. J Pathol 103:185–187

    Article  PubMed  CAS  Google Scholar 

  13. Wheatley T, Clark JD, Stewart S (1986) Craniopharyngioma with hyperprolactinaemia due to a prolactinoma. J Neurol Neurosurg Psychiatry 49:1305–1307

    PubMed  CAS  Google Scholar 

  14. Asari J, Yamanobe K, Sasaki T, Yamao N, Kodama N (1987) [A case of prolactinoma associated with craniopharyngioma]. No Shinkei Geka 15:1313–1318

  15. Cusimano MD, Kovacs K, Bilbao JM, Tucker WS, Singer W (1988) Suprasellar craniopharyngioma associated with hyperprolactinemia, pituitary lactotroph hyperplasia, and microprolactinoma. Case report. J Neurosurg 69:620–623

    PubMed  CAS  Google Scholar 

  16. Shishkina VL, Kasumova S, Snigireva R, Miakota AE (1981) [Craniopharyngioma associated with pituitary adenoma, chordoma of Blumenbach’s clivus]. Zh Vopr Neirokhir Im N N Burdenko 52–54

  17. Hazen S, Freiberg SR, Thomas C, Wallman J, Clerkin EP, Lo TC (1989) Multiple distinct intracranial tumors: association of pinealoma and craniopharyngioma. Case report. Surg Neurol 31:381–386

    Article  PubMed  CAS  Google Scholar 

  18. Belza J (1966) Double midline intracranial tumors of vestigial origin: contiguous intrasellar chordoma and suprasellar craniopharyngioma. Case report. J Neurosurg 25:199–204

    Article  PubMed  CAS  Google Scholar 

  19. Carson PC, Hellwig CA (1933) Multiple intracranial tumours in children. Suprasellar adamantinoma associated with cerebral glioma. Amer J Dis Child 46:119–131

    Google Scholar 

  20. Kim JE, Kim JH, Kim OL, Paek SH, Kim DG, Chi JG, Jung HW (2004) Surgical treatment of symptomatic Rathke cleft cysts: clinical features and results with special attention to recurrence. J Neurosurg 100:33–40

    PubMed  Google Scholar 

  21. Mukherjee JJ, Islam N, Kaltsas G, Lowe DG, Charlesworth M, Afshar F, Trainer PJ, Monson JP, Besser GM, Grossman AB (1997) Clinical, radiological and pathological features of patients with Rathke’s cleft cysts: tumors that may recur. J Clin Endocrinol Metab 82:2357–2362

    Article  PubMed  CAS  Google Scholar 

  22. Fager CA, Carter H (1966) Intrasellar epithelial cysts. J Neurosurg 24:77–81

    PubMed  CAS  Google Scholar 

  23. Shanklin WM (1951) The histogenesis and histology of an integumentary type of epithelium in the human hypophysis. Anat Rec 109:217–231

    Article  PubMed  CAS  Google Scholar 

  24. Shuangshoti S, Netsky MG, Nashold BS Jr (1970) Epithelial cysts related to sella turcica. Proposed origin from neuroepithelium. Arch Pathol 90:444–450

    PubMed  CAS  Google Scholar 

  25. Concha S, Hamilton BP, Millan JC, McQueen JD (1975) Symptomatic Rathke’s cleft cyst with amyloid stroma. J Neurol Neurosurg Psychiatry 38:782–786

    PubMed  CAS  Google Scholar 

  26. Trokoudes KM, Walfish PG, Holgate RC, Pritzker KP, Schwartz ML, Kovacs K (1978) Sellar enlargement with hyperprolactinemia and a Rathke’s pouch cyst. JAMA 240:471–473

    Article  PubMed  CAS  Google Scholar 

  27. Bader LJ, Carter KD, Latchaw RE, Ellis WG, Wexler JA, Watson JC (2004) Simultaneous symptomatic Rathke’s cleft cyst and GH secreting pituitary adenoma: a case report. Pituitary 7:39–44

    Article  PubMed  Google Scholar 

  28. Arita K, Uozumi T, Takechi A, Hirohata T, Pant B, Kubo K, Tanaka K (1994) A case of Cushing’s disease accompanied by Rathke’s cleft cyst: the usefulness of cavernous sinus sampling in the localization of microadenoma. Surg Neurol 42:112–116

    Article  PubMed  CAS  Google Scholar 

  29. Kaku S, Tanaka T, Sawauchi S, Dobashi H, Ohtsuka T, Numoto RT, Murakami S, Komine K, Abe T (2005) [A case of non-functional pituitary adenoma associated with Rathke’s cleft cyst]. No Shinkei Geka 33:797–803

  30. Inder WJ, Macfarlane MR (2004) Hyperprolactinaemia associated with a complex cystic pituitary mass: medical versus surgical therapy. Intern Med J 34:573–576

    Article  PubMed  CAS  Google Scholar 

  31. Sumida M, Migita K, Tominaga A, Iida K, Kurisu K (2001) Concomitant pituitary adenoma and Rathke’s cleft cyst. Neuroradiology 43:755–759

    Article  PubMed  CAS  Google Scholar 

  32. Nishio S, Fujiwara S, Morioka T, Fukui M (1995) Rathke’s cleft cysts within a growth hormone producing pituitary adenoma. Br J Neurosurg 9:51–55

    Article  PubMed  CAS  Google Scholar 

  33. Miyagi A, Iwasaki M, Shibuya T, Kido G, Kushi H, Miyagami M, Tsubokawa T (1993) Pituitary adenoma combined with Rathke’s cleft cyst-case report. Neurol Med Chir (Tokyo) 33:643–650

    Article  CAS  Google Scholar 

  34. Ikeda H, Yoshimoto T, Katakura R (1992) A case of Rathke’s cleft cyst within a pituitary adenoma presenting with acromegaly–do “transitional cell tumors of the pituitary gland” really exist? Acta Neuropathol (Berl) 83:211–215

    Article  CAS  Google Scholar 

  35. Ikeda H, Niizuma H, Fujiwara S, Suzuki J, Sasano N (1987) [A case of prolactinoma in close association with Rathke’s cleft cyst]. No Shinkei Geka 15:999–1003

  36. Hiyama H, Kubo O, Yato S, Kagawa M, Kitamura K (1986) [A case of pituitary adenoma combined with Rathke’s cleft cyst]. No Shinkei Geka 14:435–440

  37. Swanson SE, Chandler WF, Latack J, Zis K (1985) Symptomatic Rathke’s cleft cyst with pituitary adenoma: case report. Neurosurgery 17:657–659

    Article  PubMed  CAS  Google Scholar 

  38. Matsumori K, Okuda T, Nakayama K, Miyasaka Y, Beppu T, Kubo O (1984) [Case of calcified prolactinoma combined with Rathke’s cleft cysts]. No Shinkei Geka 12:833–838

  39. Yamakita N, Ikeda T, Murai T, Kimura M, Komaki T, Miura K, Iwamura M, Hirata T, Umezaki (1997) Panhypopituitarism due to Rathke’s cleft cyst associated with pituitary oncocytoma. Intern Med 36:107–112

    Google Scholar 

  40. Cruz-Soto ME, Scheiber MD, Gregerson KA, Boivin GP, Horseman ND (2002) Pituitary tumorigenesis in prolactin gene-disrupted mice. Endocrinology 143:4429–4436

    Article  PubMed  CAS  Google Scholar 

  41. Vidal S, Horvath E, Syro LV, Uribe H, Cohen S, Kovacs K (2002) Prolactin-producing pituitary adenoma associated with prolactin cell hyperplasia. Endocr Pathol 13:157–165

    Article  PubMed  CAS  Google Scholar 

  42. Kovacs K, Stefaneanu L, Ezzat S, Smyth HS (1994) Prolactin-producing pituitary adenoma in a male-to-female transsexual patient with protracted estrogen administration. A morphologic study. Arch Pathol Lab Med 118:562–565

    PubMed  CAS  Google Scholar 

  43. Scheithauer BW, Kovacs KT, Randall RV, Ryan N (1989) Effects of estrogen on the human pituitary: a clinicopathologic study. Mayo Clin Proc 64:1077–1084

    PubMed  CAS  Google Scholar 

  44. Ackland FM, Stanhope R, Preece MA (1987) Cushing’s disease and craniopharyngioma. Arch Dis Child 62:1077–1078

    Article  PubMed  CAS  Google Scholar 

  45. Caceres A, Reitman AJ, Tomita T (2005) Craniopharyngioma and Cushing disease: case report. J Neurosurg 102:318–321

    PubMed  Google Scholar 

  46. Karavitaki N, Cudlip S, Adams CB, Wass JA (2006) Craniopharyngiomas. Endocr Rev 27(4):371-397

    Article  PubMed  Google Scholar 

  47. Gorlin RJ, Chaudhry AP (1959) The ameloblastoma and the craniopharyngioma; their similarities and differences. Oral Surg Oral Med Oral Pathol 12:199–205

    Article  PubMed  CAS  Google Scholar 

  48. Bernstein ML, Buchino JJ (1983) The histologic similarity between craniopharyngioma and odontogenic lesions: a reappraisal. Oral Surg Oral Med Oral Pathol 56:502–511

    Article  PubMed  CAS  Google Scholar 

  49. Seemayer TA, Blundell JS, Wiglesworth FW (1972) Pituitary craniopharyngioma with tooth formation. Cancer 29:423–430

    Article  PubMed  CAS  Google Scholar 

  50. Sarubi JC, Bei H, Adams EF, Boson WL, Friedman E, Brandao K, Kalapothakis E, Miranda D, Valle FL, Sarquis MS, De Marco L (2001) Clonal composition of human adamantinomatous craniopharyngiomas and somatic mutation analyses of the patched (PTCH), Gsalpha and Gi2alpha genes. Neurosci Lett 310:5–8

    Article  PubMed  CAS  Google Scholar 

  51. Gorski GK, McMorrow LE, Donaldson MH, Freed M (1992) Multiple chromosomal abnormalities in a case of craniopharyngioma. Cancer Genet Cytogenet 60:212–213

    Article  PubMed  CAS  Google Scholar 

  52. Karnes PS, Tran TN, Cui MY, Raffel C, Gilles FH, Barranger JA, Ying KL (1992) Cytogenetic analysis of 39 pediatric central nervous system tumors. Cancer Genet Cytogenet 59:12–19

    Article  PubMed  CAS  Google Scholar 

  53. Rienstein S, Adams EF, Pilzer D, Goldring AA, Goldman B, Friedman E (2003) Comparative genomic hybridization analysis of craniopharyngiomas. J Neurosurg 98:162–164

    PubMed  CAS  Google Scholar 

  54. Sekine S, Shibata T, Kokubu A, Morishita Y, Noguchi M, Nakanishi Y, Sakamoto M, Hirohashi S (2002) Craniopharyngiomas of adamantinomatous type harbor beta-catenin gene mutations. Am J Pathol 161:1997–2001

    PubMed  CAS  Google Scholar 

  55. Buslei R, Nolde M, Hofmann B, Meissner S, Eyupoglu IY, Siebzehnrubl F, Hahnen E, Kreutzer J, Fahlbusch R (2005) Common mutations of beta-catenin in adamantinomatous craniopharyngiomas but not in other tumours originating from the sellar region. Acta Neuropathol (Berl) 109:589–597

    Article  CAS  Google Scholar 

  56. Hassanein AM, Glanz SM, Kessler HP, Eskin TA, Liu C (2003) Beta-Catenin is expressed aberrantly in tumors expressing shadow cells. Pilomatricoma, craniopharyngioma, and calcifying odontogenic cyst. Am J Clin Pathol 120:732–736

    Article  PubMed  CAS  Google Scholar 

  57. Kato K, Nakatani Y, Kanno H, Inayama Y, Ijiri R, Nagahara N, Miyake T, Tanaka M, Ito Y, Aida N, Tachibana K, Sekido K, Tanaka Y (2004) Possible linkage between specific histological structures and aberrant reactivation of the Wnt pathway in adamantinomatous craniopharyngioma. J Pathol 203:814–821

    Article  PubMed  CAS  Google Scholar 

  58. Kepes JJ (1978) Transitional cell tumor of the pituitary gland developing from a Rathke’s cleft cyst. Cancer 41:337–343

    Article  PubMed  CAS  Google Scholar 

  59. Nishio S, Mizuno J, Barrow DL, Takei Y, Tindall GT (1987) Pituitary tumors composed of adenohypophysial adenoma and Rathke’s cleft cyst elements: a clinicopathological study. Neurosurgery 21:371–377

    Article  PubMed  CAS  Google Scholar 

  60. Kunwar S, Wilson CB (2002) Cysts, hamartomas and vascular tumours. In: Wass JAH, Shalet SM (eds) Oxford Textbook of Endocrinology and Diabetes. Oxford University Press, Oxford, pp 225–230

    Google Scholar 

  61. Harrison MJ, Morgello S, Post KD (1994) Epithelial cystic lesions of the sellar and parasellar region: a continuum of ectodermal derivatives? J Neurosurg 80:1018–1025

    PubMed  CAS  Google Scholar 

  62. Asa SL, Ezzat S (1998) The cytogenesis and pathogenesis of pituitary adenomas. Endocr Rev 19:798–827

    Article  PubMed  CAS  Google Scholar 

  63. Melmed S (2003) Mechanisms for pituitary tumorigenesis: the plastic pituitary. J Clin Invest 112:1603–1618

    PubMed  CAS  Google Scholar 

  64. Oikonomou E, Barreto DC, Soares B, De Marco L, Buchfelder M, Adams EF (2005) Beta-catenin mutations in craniopharyngiomas and pituitary adenomas. J Neurooncol 73:205–209

    Article  PubMed  CAS  Google Scholar 

  65. Tziortzioti V, Ruebel KH, Kuroki T, Jin L, Scheithauer BW, Lloyd RV (2001) Analysis of beta-catenin mutations and alpha-, beta-, and gamma-catenin expression in normal and neoplastic human pituitary tissues. Endocr Pathol 12:125–136

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Endocrinology, Oxford Centre for Diabetes, Endocrinology and Metabolism, Churchill Hospital, Oxford, UK

    N. Karavitaki & J. A. H. Wass

  2. Division of Anatomic Pathology Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 First Street, SW, Rochester, MN, 55905, USA

    B. W. Scheithauer & J. Watt

  3. Neuropathology Department, Radcliffe Infirmary, Oxford, UK

    O. Ansorge

  4. Department of Pathology, Kantonsspital Aarau, Aarau, Switzerland

    M. Moschopoulos

  5. Department of Neurosurgery, Kaiser Hospital, Sacramento, CA, USA

    A. V. Llaguno

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  1. N. Karavitaki
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  2. B. W. Scheithauer
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  3. J. Watt
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  4. O. Ansorge
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Correspondence to B. W. Scheithauer.

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Karavitaki, N., Scheithauer, B.W., Watt, J. et al. Collision lesions of the sella: co-existence of craniopharyngioma with gonadotroph adenoma and of Rathke’s cleft cyst with corticotroph adenoma. Pituitary 11, 317–323 (2008). https://doi.org/10.1007/s11102-007-0070-6

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