Dual Hormonal Presentation in a Rare Sellar Gangliocytoma: Diagnostic and Pathological Insights from a Collision Tumor.

Abstract

Background: Gangliocytomas of the sellar region are rare, well-differentiated, benign tumors that may coexist with pituitary adenomas, forming so-called "collision tumors." These lesions often present with endocrine dysfunction, most commonly acromegaly.

Case description: We report a 69-year-old female who presented with drug-resistant headaches, acromegalic features, and signs of Cushing's disease. Magnetic resonance imaging showed a sellar mass with extension into the clivus. Endoscopic transsphenoidal resection revealed a tumor composed of ganglion cells and adenohypophyseal components. Immunohistochemistry confirmed a diagnosis of gangliocytoma coexisting with a hormone-secreting pituitary adenoma. Postoperative hormonal normalization was achieved.

Conclusion: Sellar gangliocytomas with dual hormonal activity pose diagnostic challenges and highlight the importance of histological and immunohistochemical evaluation. Awareness of these rare entities can prevent misdiagnosis and support appropriate surgical management.