Endocrine Abstracts (2009) 20 P286

Gasser ganglion as pituitary tumor - case report

Mara Carsote1, Dan Peretianu2, Adriana Gruia3, Cristina Ene4, Dan Hortopan4 & Catalina Poiana1,4

1Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; 2SCM Povernei, Bucharest, Romania; 3Medlife Medical Centre, Bucharest, Romania; 4CI Parhon National Institute of Endocrinology, Bucharest, Romania.

Introduction: The Gasser Ganglion is a large semi lunar-shaped ganglion of the trigeminal nerve. It contains the cells of origin of the most sensory fibers of the fifth cranial nerve.

Aim: Our purpose is to describe a case where Gasser ganglion has an anatomic variant (near the sella turcica), mimicking a hypophyseal tumor.

Case presentation: Of 17 years female patient has a history of bradispaniomenorrhea (menses at 30–50 days) since the last year with no galacthorrea. She associates increased serum prolactin (816 μUI/ml, with normal level below 492), and 6 months later 65.31 ng/ml (normal limit below 24). No other causes of hyperprolactinemia were detected except from a pituitary hypodense tumor of 0.6 by 0.52 cm, having a density of 41 Haussfield Units, as revealed by computed tomography (CT). But also right retrosellar it was discovered another hypodense area, on the median line, which seemed to be an evidential gasserian ganglion. The diagnosis of microprolactinoma was considered and treatment with dopamine agonists as bromocriptin 7.5 mg per day was recommended. 6 months later, the patient tried to stop the medication by her own initiative. The prolactin raised to 117.43 ng/ml (normal below 24 ng/ml). The CT scan showed mainly the same dimensions of the tumor, but a higher density (92HU). The therapy was initiated again.

Conclusion: The anatomic disturbance of the Gasser ganglion represents a differential diagnosis for pituitary or retrosellar masses as microprolactinoma in our case.

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