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Mixed gangliocytoma-pituitary neuroendocrine tumour: clinical, immunohistochemical, and molecular genetic profiles in a series of four patients
Sahlgrens Univ Hosp, Dept Endocrinol, Gothenburg, Sweden.;Univ Gothenburg, Inst Med, Sahlgrenska Acad, Dept Internal Med & Clin Nutr, Gothenburg, Sweden..
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Endocrinology and mineral metabolism.ORCID iD: 0000-0003-4514-5193
KTH Royal Inst Technol, Sci Life Lab, Dept Prot Sci, Stockholm, Sweden.;Normandie Univ, Referral Ctr Lysosomal Dis, Dept Metab Biochem, UNIROUEN,CHU Rouen,AIMS,SysMedLab,Filiere G2M, Rouen, France..
Sahlgrens Univ Hosp, Dept Clin Pathol, Gothenburg, Sweden.;Univ Gothenburg, Inst Neurosci & Physiol, Sahlgrenska Acad, Dept Physiol, Gothenburg, Sweden..
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2026 (English)In: Acta neuropathologica communications, E-ISSN 2051-5960, Vol. 14, no 1, article id 48Article in journal (Refereed) Published
Abstract [en]

The vast majority of tumours in the sellar region are pituitary neuroendocrine tumours, also called pituitary adenomas. Sellar gangliocytomas (GCs), benign tumours that originate from neuronal ganglionic cells, account for less than 1% of sellar tumours. Even rarer are mixed gangliocytoma-pituitary neuroendocrine tumours (GC-PitNET). These tumours are often associated with hormone hypersecretion, most commonly resulting in acromegaly. The histogenesis of mixed GC-PitNET is currently unclear. In this paper, we present comprehensive clinical, immunohistochemical, targeting enrichment next generation DNA sequencing, and genome-wide methylation data from four patients with mixed GC-PitNETs, three with acromegaly and one with Cushing's disease. Transcriptomic data are also included for two of the patients. Our findings indicate that mixed GC-PitNETs have different clinical course, with the acromegaly patients showing greater resistance to pharmacological therapy, as well as different protein expression and molecular features compared to respective pure PitNETs. The transcriptomic data on two patients with somatotroph GC-PitNET show involvement of mitochondrial and ribosomal genes, suggesting a distinct gene expression pattern, in comparison with pure somatotroph tumours. Furthermore, the expression pattern of selected stem cell markers, mainly SOX9, supports a common origin of the neuroendocrine and ganglionic tumour components, suggesting the involvement of stem cells in tumorigenesis.

Place, publisher, year, edition, pages
Springer Nature, 2026. Vol. 14, no 1, article id 48
Keywords [en]
Mixed gangliocytoma-pituitary adenoma, Mixed gangliocytoma-PitNET, PANCH, Acromegaly, Cushing's disease
National Category
Endocrinology and Diabetes Cancer and Oncology Clinical Laboratory Medicine
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URN: urn:nbn:se:uu:diva-582089DOI: 10.1186/s40478-026-02225-xISI: 001698726100001PubMedID: 41618392Scopus ID: 2-s2.0-105031011525OAI: oai:DiVA.org:uu-582089DiVA, id: diva2:2052143
Available from: 2026-04-10 Created: 2026-04-10 Last updated: 2026-04-10Bibliographically approved

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Edén Engström, BrittNord, HelenaLindskog, CeciliaPontén, FredrikCasar-Borota, Olivera

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Endocrinology and mineral metabolismDepartment of Immunology, Genetics and PathologyScience for Life Laboratory, SciLifeLabCancer precision medicine
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