Faculty Collaboration Database

Comparative analysis of growth hormone-secreting mixed gangliocytomas and pure growth hormone pituitary adenomas. Clin Neurol Neurosurg 2025 Oct;257:109097

Date

08/13/2025

Pubmed ID

40795519

DOI

10.1016/j.clineuro.2025.109097

Scopus ID

2-s2.0-105012919996 (requires institutional sign-in at Scopus site)

Abstract

INTRODUCTION: Mixed gangliocytoma-pituitary adenomas (MGPAs) are rare sellar tumors, often presenting with signs and symptoms of acromegaly due to the somatotrophic component. The pathogenesis is not well understood, with few cases reported. We present our institutional experience in surgical management and compare surgical outcomes in growth hormone (GH)-secreting MGPAs and GH-secreting pituitary adenomas (GHPAs).

METHODS: We retrospectively reviewed demographic and clinical data of adult patients with MGPAs and GHPAs operated at our institution from 2018 to 2024.

RESULTS: Six MGPA patients (3 males, 3 females) and 40 GHPA patients (20 males, 20 females) were included. Mean age was 47 (range 36-65) and 49 years (range 19-76), respectively. Common symptoms in both groups were headaches, acral enlargement, and facial changes. All patients underwent endoscopic endonasal transsphenoidal approach (EETA). Preoperative mean IGF-1 levels were similar. Tumor diameter was larger in MGPA (23 mm vs. 15 mm, p = 0.034). Cavernous sinus invasion Knosp 4 was more common in MGPA (16 %) than GHPA (5 %) (p = 0.121). Hormonal remission, defined as normalized IGF-1 at 3-6 months postoperatively, was achieved in 50 % of MGPA and 48 % of GHPA patients. Mean follow-up time for MGPA and GHPA patients was 19 months and 34 months respectively. Neither group experienced disease recurrence.

DISCUSSION: MGPA is a rare subtype of pituitary adenoma; however, it represented 12.8 % of operated GH-secreting tumors at our institution. In our series, MGPAs were larger tumors and more likely to invade the cavernous sinus than GHPAs. EETA was safe and effective in both groups, with similar remission rates.

Author List

Mattheisen H, Peterson A, Memon A, Mrachek EKS, Tavakoli S, Ioachimescu A, Zwagerman N, Cheok S

Authors

Stephanie K. Cheok MD Assistant Professor in the Neurosurgery department at Medical College of Wisconsin
Nathan Zwagerman MD Associate Professor in the Neurosurgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adenoma
Adult
Aged
Female
Ganglioneuroma
Growth Hormone-Secreting Pituitary Adenoma
Humans
Male
Middle Aged
Neurosurgical Procedures
Pituitary Neoplasms
Retrospective Studies
Treatment Outcome
Young Adult