Abstract
Salivary gland rests occur in the posterior lobe of the pituitary gland near or often communicating with the Rathke's cleft or its cystic subdivisions, and are usually incidental autopsy findings. They are attributed to the oropharyngeal development of the Rathke's pouch and may rarely give rise to salivary gland-like tumors in the sella. We present a pleomorphic adenoma, a rare tumor of the sellar region, that has not been previously recognized in association with Rathke's cleft cyst. It occurred in a 44-year-old man who presented with hypopituitarism and reduced vision. Magnetic resonance imaging showed a sellar mass with suprasellar extension which was totally removed. It consisted of segments of a cyst wall lined by focally ciliated columnar of cuboid epithelium containing goblet cells. An eosinophilic granular material with cholesterol clefts represented the contents of the cyst. Within its wall there was a tumor with ductal structures and non-ductal varied cellular components including hypercellular areas of spindle and ovoid cells forming interlacing fascicles. Individual cells appeared to float in abundant mucinous material. The appearances were those of a salivary gland pleomorphic adenoma arising within the wall of a Rathke's cleft cyst. The myoepithelial nature of non-ductal tumor cells was confirmed with immunocytochemistry. The existence of seromucous glands communicating with the Rathke's cleft remnants, explains the concomitant occurrence of the tumor and the cyst. This rare neoplasm from salivary gland rest should be considered in the differential diagnosis of unusual sellar and suprasellar tumors.
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References
Mc Keever PE, Blaivas M, Sima AAF. Neoplasms of the sellar region. In: Lloyd RV, Ed. Surgical Pathology of the Pituitary Gland, vol 27 in the series Major Problems in Pathology. Philadelphia: WB Saunders Company 1993:141–211.
Asa SL. Tumors of the pituitary gland. In the series Atlas of Tumor Pathology, Third Series, Fascicle 22. Washington DC: Armed Forces Institute of Pathology, 1998.
Schochet SS Jr, McCormick WF, Halmi NS. Salivary gland rests in the human pituitary: Light and electron microscopical study. Arch Pathol 1974;98:193–200.
Hampton TA, Scheithauer BW, Rojiani AM, Kovacs K, Horvath E, Vogt P. Salivary gland-like tumors of the sellar region. Am J Surg Pathol 1997;21:424–434.
Scheithauer BW. Pathology of the pituitary and sellar region: exclusive of pituitary adenoma. Pathology Annual 1985. Part I, Norwalk, CT: Appleton Century Crofts, 1985: 67–155.
Kato T, Aida T, Abe H, Miyamachi K, Hida K, Taneda M, Ogata A. Ectopic salivary gland within the pituitary gland. Case report. Neurol Med Chir 1988;28:930–933.
Schaetti P, Argentino Storino A, Heinrichs M, Mirea D, Popp A, Karbe E. Aberrant craniopharyngeal structures within the neurohypophysis of rats. Exp Toxicol Pathol 1995;47:129–137.
Tatter SB, Edgar MA, Klibanski A, Swearingen B. Symptomatic salivary-rest cyst of the sella turcica. Acta Neurochir (Wien) 1995;135:150–153.
Yamakita N, Ikeda T, Murai T, Kimura M, Komaki T, Miura K, Iwamura M, Hirata T, Umezaki. Panhypopituitarism due to Rathke's cleft cyst associated with pituitary oncocytoma. Intern Med 1997;36:107–112.
Gilcrease MZ, Delgado R, Albores Saavedra J. Intrasellar adenoid cystic carcinoma and papillary mucinous adenocarcinoma: Two previously undescribed primary neoplasms at this site. Ann Diagn Pathol 1993;3:141–147.
Stead RH, Qizilbash AH, Kontozoglou T, Daya AD, Riddell RH. An immunohistochemical study of pleomorphic adenomas of the salivary gland: Glial fibrillary acidic proteinlike immunoreactivity identifies a major myoepithelial component. Hum Pathol 1988;19:32–40.
Ellis GL, Auclair PL. Tumors of the salivary glands. In the series Atlas of Tumor Pathology. Third Series, Fascicle 17. Washington DC, Armed Forces Institute of Pathology. 1996.
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Chimelli, L., Gadelha, M., Une, K. et al. Intra-sellar Salivary Gland-like Pleomorphic Adenoma Arising within Wall of a Rathke's Cleft Cyst. Pituitary 3, 257–261 (2000). https://doi.org/10.1023/A:1012888315577
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DOI: https://doi.org/10.1023/A:1012888315577