Suprasellar granular cell tumor of the neurohypophysis: surgical outcome of a very rare tumor

Pituitary. 2016 Jun;19(3):277-85. doi: 10.1007/s11102-016-0704-7.


Purpose: Granular cell tumors of the neurohypophysis are rare, solitary lesions, mostly presenting in the adult age. They rarely grow to a sufficient size to cause mass effect related symptoms and they may be found in most cases incidentally at autopsy. Because of their rarity as of now they have been described only as case reports or included in small clinical series.

Methods: We report a series of 11 patients, who underwent surgery for granular cell tumors of the neurohypophysis between 1996 and 2013 in a single center.

Results: Mean follow-up time after treatment was 92.2 months (range 9-231 months). Mean age at surgery was 40.7 years (range 12-66 years). There were 7 males (63.6 %) and 4 females (36.4 %). Main symptoms at presentation were: hyperprolactinemia (72.7 %), visual impairment (45.5 %) and headache (36 %). Except for 2 patients, all the others underwent surgery as primary treatment at our Institution, through a transsphenoidal (54.5 %) or a transcranial approach (45.5 %). Overall- and progression-free survival times for the entire series (calculated from the time of diagnosis) were 112.9 and 100.5 months respectively. There was one case of perioperative death in a patient who had undergone repeat transcranial surgery for residual tumor.

Conclusions: Although extremely rare, granular cell tumors of the neurohypophysis have to be considered in the differential diagnosis of suprasellar masses, to avoid misleading interpretation and consequent wrong therapeutic management. Early diagnosis, extensive tumor removal, opportune indication of adjuvant radiotherapy are the keys to manage these cases.

Keywords: Granular cell tumor; Neurohypophysis; Pituitary neoplasm; Radiotherapy.

MeSH terms

  • Acromegaly / etiology
  • Adolescent
  • Adult
  • Aged
  • Child
  • Cranial Irradiation
  • Diabetes Insipidus / etiology
  • Disease-Free Survival
  • Female
  • Granular Cell Tumor / complications
  • Granular Cell Tumor / diagnostic imaging
  • Granular Cell Tumor / pathology
  • Granular Cell Tumor / surgery*
  • Gynecomastia / etiology
  • Humans
  • Hyperprolactinemia / etiology
  • Hypophysectomy*
  • Hypothyroidism / etiology
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Pituitary Gland, Posterior*
  • Pituitary Neoplasms / complications
  • Pituitary Neoplasms / diagnostic imaging
  • Pituitary Neoplasms / pathology
  • Pituitary Neoplasms / surgery*
  • Radiotherapy, Adjuvant*
  • Vision Disorders / etiology
  • Young Adult

Supplementary concepts

  • Growth hormone excess