Mattheisen Hailey, Peterson Abigail, Memon Abdullah, Mrachek E Kelly S, Tavakoli Samon, Ioachimescu Adriana, Zwagerman Nathan, Cheok Stephanie
Department of Neurosurgery, Medical College of Wisconsin and Froedtert Hospital, 8701 Watertown Plank Rd, Wauwatosa, WI 53226, USA.
Department of Pathology, Medical College of Wisconsin and Froedtert Hospital, 8701 Watertown Plank Rd, Wauwatosa, WI 53226, USA.
Clin Neurol Neurosurg. 2025 Oct;257:109097. doi: 10.1016/j.clineuro.2025.109097. Epub 2025 Aug 5.
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).
We retrospectively reviewed demographic and clinical data of adult patients with MGPAs and GHPAs operated at our institution from 2018 to 2024.
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.
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.
混合性神经节细胞瘤-垂体腺瘤（MGPAs）是罕见的鞍区肿瘤，由于生长激素分泌成分，常表现为肢端肥大症的体征和症状。其发病机制尚不清楚，报道的病例较少。我们介绍我们机构在手术治疗方面的经验，并比较生长激素（GH）分泌型MGPAs和GH分泌型垂体腺瘤（GHPAs）的手术结果。
我们回顾性分析了2018年至2024年在我们机构接受手术的成年MGPAs和GHPAs患者的人口统计学和临床数据。
纳入6例MGPA患者（3例男性，3例女性）和40例GHPA患者（20例男性，20例女性）。平均年龄分别为47岁（范围36 - 65岁）和49岁（范围19 - 76岁）。两组的常见症状均为头痛、肢端增大和面部改变。所有患者均接受了鼻内镜经蝶窦入路（EETA）。术前平均IGF - 1水平相似。MGPA的肿瘤直径更大（23毫米对15毫米，p = 0.034）。海绵窦侵袭Knosp 4级在MGPA中（16%）比GHPA中（5%）更常见（p = 0.121）。激素缓解定义为术后3 - 6个月IGF - 1正常化，50%的MGPA患者和48%的GHPA患者实现了激素缓解。MGPA和GHPA患者的平均随访时间分别为19个月和34个月。两组均未出现疾病复发。
MGPA是垂体腺瘤的一种罕见亚型；然而，在我们机构，它占接受手术的GH分泌型肿瘤的12.8%。在我们的系列研究中，MGPAs比GHPAs肿瘤更大，更易侵袭海绵窦。EETA在两组中均安全有效，缓解率相似。
