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---
-title: "Granular Cell Tumor"
-docid: "da976b04-85a3-4bf8-ac81-e579f081293e"
-breadcrumbs:
-  - "Brain"
-  - "Diagnosis"
-  - "Anatomy-Based Diagnoses"
-  - "Sella and Pituitary"
-  - "Neoplasms"
-  - "Granular Cell Tumor"
---
-# KEY FACTS
-
- ## Terminology
-  
-  
-    - Neoplasms that arise from pituicytes, specialized glial cells of neurohypophysis or infundibulum
-    - Rare low-grade, nonendocrine neoplasms of sellar region
-    - Formerly called pituicytoma; granular cell tumor of neurohypophysis
-    - Part of 2017 WHO spectrum of thyroid transcription factor 1 (TTF-1) expressing pituitary tumors of posterior lobe
- ## Imaging
-  
-  
-    - Enhancing, well-circumscribed sellar/suprasellar or infundibular mass
-    - 1.5-6.0 cm
-    - CT: Sellar/suprasellar mass with hyperattenuation
-          - Rarely calcification may be present
-    - Best imaging tool: C+ MR with high-resolution imaging through sellar region
-    - Consider granular cell tumor if sellar/suprasellar mass appears separate from anterior pituitary gland
- ## Top Differential Diagnoses
-  
-  
-    - Pituitary macroadenoma
-    - Lymphocytic hypophysitis
-    - Pituicytoma
-    - Spindle cell oncocytoma
-    - Rathke cleft cyst
- ## Pathology
-  
-  
-    - WHO grade 1
- ## Clinical Issues
-  
-  
-    - Commonly asymptomatic (small lesions)
-    - Visual field deficit related to optic chiasm compression is most common presenting feature
-    - Less common symptoms: Panhypopituitarism, galactorrhea, amenorrhea, decreased libido, neuropsychological changes
-    - Typically present in adulthood, 5th-6th decades
-    - Generally benign clinical course
-
-# TERMINOLOGY
-
- ## Abbreviations
-  
-  
-    - Granular cell tumor (GCT)
- ## Synonyms
-  
-  
-    - Formerly called pituicytoma; granular cell tumor of neurohypophysis
- ## Definitions
-  
-  
-    - Neoplasms that arise from pituicytes, specialized glia of neurohypophysis or infundibulum
-    - Rare low-grade, nonendocrine neoplasms of sellar region
-    - Part of 2017 WHO spectrum of thyroid transcription factor1 (TTF-1) expressing pituitary tumors of posterior lobe
-
-# IMAGING
-
- ## General Features
-  
-  
-    - ### Best diagnostic clue
-      
-      
-          - Enhancing, well-circumscribed sellar/suprasellar or infundibular mass
-    - ### Location
-      
-      
-          - Sellar and suprasellar or infundibular mass
-    - ### Size
-      
-      
-          - 1.5-6.0 cm
-    - ### Morphology
-      
-      
-          - Lobulated and well circumscribed
- ## CT Findings
-  
-  
-    - ### NECT
-      
-      
-          - Sellar/suprasellar mass with hyperattenuation
-          - Rarely calcification may be present
- ## MR Findings
-  
-  
-    - ### T1WI
-      
-      
-          - Sellar/suprasellar mass isointense to gray matter
-    - ### T1WI C+
-      
-      
-          - Enhancement may be homogeneous or heterogeneous
- ## Imaging Recommendations
-  
-  
-    - ### Best imaging tool
-      
-      
-          - C+ MR with high-resolution imaging through sellar region
-
-# DIFFERENTIAL DIAGNOSIS
-
- [Pituitary Macroadenoma](/document/pituitary-microadenoma/283f3068-d369-4f79-bf01-0f2b82c6e49b)
-    - Sellar and suprasellar enhancing mass
-    - Arises from adenohypophysis
-    - May be indistinguishable
- [Lymphocytic Hypophysitis](/document/lymphocytic-hypophysitis/f30774c3-cbd0-4ab3-b3d1-e0574106db1f)
-    - May be indistinguishable from macroadenoma
-    - May present as infundibular mass
-    - Typically pregnant or postpartum females
- [Pituicytoma](/document/pituicytoma/d6e481d5-7742-4354-8dfe-4f04286a709a)
-    - May be intrasellar or suprasellar mass
-    - May be separate from adenohypophysis
- [Spindle Cell Oncocytoma](/document/spindle-cell-oncocytoma/1557bfb2-8315-4782-9a1e-4e70d6d20c4e)
-    - Imaging mimics macroadenoma
-    - Enhancing sellar and suprasellar mass
- [Rathke Cleft Cyst](/document/rathke-cleft-cyst/8f1561f7-92a7-485c-a0ae-2e2d5c8c1628)
-    - Nonenhancing cystic sellar &/or suprasellar lesion
-    - Intracystic nodule in up to 75%
-
-# PATHOLOGY
-
- ## General Features
-  
-  
-    - ### Associated abnormalities
-      
-      
-          - Granular cell tumors have been found in associated with adenomas
-          - Small granular cell clusters have been found in up to 17% of autopsy series
- ## Staging, Grading, & Classification
-  
-  
-    - WHO grade 1
- ## Gross Pathologic & Surgical Features
-  
-  
-    - Lobulated, well-circumscribed mass, soft but rubbery
-    - More firm than pituitary adenoma
- ## Microscopic Features
-  
-  
-    - Densely packed polygonal cells with abundant granular eosinophilic cytoplasm
-    - Electron microscopy: Cytoplasm is filled with phagolysosomes containing electron-dense material and membranous debris
-
-# CLINICAL ISSUES
-
- ## Presentation
-  
-  
-    - ### Most common signs/symptoms
-      
-      
-          - Commonly asymptomatic (small lesions)
-          - Visual field deficit related to optic chiasm compression
-    - ### Other signs/symptoms
-      
-      
-          - Panhypopituitarism, galactorrhea, amenorrhea, decreased libido, neuropsychological changes
-          - Rarely diabetes insipidus
- ## Demographics
-  
-  
-    - ### Age
-      
-      
-          - Typically present in adulthood, 5th-6th decades
-    - ### Gender
-      
-      
-          - F:M = 2:1
- ## Natural History & Prognosis
-  
-  
-    - Rare (~ 150 reported cases)
-    - Generally benign clinical course
- ## Treatment
-  
-  
-    - Surgical resection
-
-# DIAGNOSTIC CHECKLIST
-
- ## Image Interpretation Pearls
-  
-  
-    - Consider granular cell tumor if sellar/suprasellar mass appears separate from anterior pituitary gland
-
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