J Korean Endocr Soc.  2007 Dec;22(6):436-439. 10.3803/jkes.2007.22.6.436.

A Case Report of Symptomatic Salivary Gland Rest within the Pituitary Gland

• Kim TH
• Park TJ
• Kim HJ
• Kim DJ
• Chung YS
• Lee KW
• Lee TH
• Kim HS
• Cho KG

• KMID: 1958908
• DOI: http://doi.org/10.3803/jkes.2007.22.6.436

Abstract

Although salivary gland tissues in the posterior pituitary are occasionally observed in microscopic examination at autopsy, these tissues are considered clinically silent. Only three examples of symptomatic salivary tissues in the pituitary have been previously reported. We report a case of symptomatic salivary gland rest within the pituitary gland. A 19-year-old woman complained of headache for 2 months, and dizziness, nausea, blurred vision for 1 week. Magnetic resonance imaging revealed a 1.8 cm-sized mass in sella turcica with hyperintensity on T1-weighted images. Basal hormone levels and combined pituitary stimulation test were normal. The trans-sphenoidal approach of tumor removal was performed and a pathological examination confirmed salivary gland rest without any evidence of a pituitary adenoma. The symptoms had disappeared, except for post-operative diabetes insipidus.

Keyword

salivary gland rest; pituitary gland

MeSH Terms

Autopsy
Diabetes Insipidus
Dizziness
Female
Headache
Humans
Magnetic Resonance Imaging
Nausea
Pituitary Gland*
Pituitary Neoplasms
Salivary Glands*
Sella Turcica
Young Adult

Figure

• 

  Fig. 1 MRI demonstrated about 1.8 cm mass in the pituitary gland (A, B. T1 weighted images, C, D. post-contrast T1 weighted images). The lesion was hyper-intense on T1 weighted images, and showed enhancement on post-contrast T1 weighted images.

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  Fig. 2 Histology of the salivary gland rest in the posterior lobe of pituitary gland. Microscopic examination showed the cyst wall to consist entirely of seromucinous acini with a low-columnar to cuboidal epithelium in a fibrovascular stroma. (A. H&E stain ×100; B. H&E stain ×400)

Reference

1. Costello RT. Subclinical adenoma of the pituitary gland. Am J Pathol. 1936. 12:205.

2. Earle KM, Dillard SH Jr. Pathology of adenomas of the pituitary gland. 1973. Amsterdam: Excerpta Medica;Excerpta Medica International Congress Series no. 303.

3. Martinez AJ. The pathology of non-functioning pituitary adenomas. Semin Diagn Pathol. 1986. 3:83–94.

4. McComb DJ, Ryan N, Horvath E, Kovacs K. Subclinical adenomas of the human pituitary. New light on old problems. Arch Pathol Lab Med. 1983. 107:488–491.

5. 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.

6. Schochet SS, McCormick WF, Halmi NS. Salivary gland rests in the human pituitary: light and electron microscopical study. Arch Pathol. 1974. 98:193–200.

7. Gudbrandsson FK, Liston SL, Maisel RA. Heterotopic salivary tissue in the neck. Otolaryngol Head Neck Surg. 1982. 90:279–282.

8. Rodriguez F, Scheithauer BW, Ockner DM, Giannini C. Solitary fibrous tumor of the cerebellopontine angle with salivary gland heterotopia: a unique presentation. Am J Surg Pathol. 2004. 28:139–142.

9. Weitzner S. Ectopic salivary gland tissue in submucosa of rectum. Dis Colon Rectum. 1983. 26:814–817.

10. Dubois PM, el Amraoui A, Heritier AG. Development and differentiation of pituitary cells. Microsc Res Tech. 1997. 39:98–113.

11. Kusakabe M, Sakakura T, Sano M, Nishizuka Y. A pituitary-salivary mixed gland induced by tissue recombination of embryonic pituitary epithelium and embryonic submandibular gland mesenchyme in mice. Dev Biol. 1985. 110:382–391.

12. Kato T, Aida T, Abe H, Miyamachi K, Hida K, Taneda M, Ogata A. Ectopic salivary gland in the pituitary gland: case report. Neurol Med Chir. 1988. 28:930–933.

13. Tatter SB, Edgar MA, Klibanski A, Swearingen B. Symptomatic salivary-rest cyst of the sellar turcica. Acta Neurochir (Wien). 1995. 135:150–153.

14. Chen CH, Hsu SS, Lai PH, Lo YS. Intrasellar symptomatic salivary gland rest: case report. J Chin Med Assoc. 2007. 70:215–217.