Istinct appearing components of the tumor is not clear from the present study; however, several mechanisms can be hypothesized. One hypothesis is that this tumor is composed of two independent primary neoplasms; however, the intimate admixture of the two components makes this explanation unlikely. Alternatively, the two components of this tumor could have arisen from a common tumor stem cell through divergent differentiation. Activation of factors involved in normal embryonic development could have led to cells resembling primordial cells of rathke's pouch that then could differentiate into the pars tuberalis (leading to craniopharyngioma development) and the pars distalis (leading to pituitary adenoma development). order viagra online Pituitary cells with stem cell characteristics have been described in adults (2), and these cells also could be the source of the two coexisting pituitary tumors. Another theoretical mechanism could be divergent differentiation of one neoplasm into the other. physical effects of viagra on women Interestingly, normal adenohypophyseal cells have been documented to have plasticity in differentiation. cialis and viagra generic Lactotrophs and somatotrophs can change their phenotype through transdifferentiation (8). viagra company headquarters This process can be adaptive as recruitment of cells of one type to secrete hormones of another cell type can meet increased physiological needs (6). A more frequently reported form of divergent differentiation in pituitary adenomas is the presence of ganglion cells found in some adenomas with neuronal differentiation (4). Based on the data presented, we suggest that the nests of craniopharyngioma found in this pituitary adenoma represent islands of an unusual form of divergent differentiation in a pituitary adenoma. viagra response time References asari j, yamanobe k, sasaki t, yamao n, kodama n (1987) a case of prolactinoma associated with craniopharyngioma. No shinkei geka. buy generic viagra online 15(12):1313-8. Chen j, hersmus n, van duppen v, caesens p, denef c, vankelecom h (2005) the adult pituitary contains a cell population displaying stem/progenitor cell and early embryonic characteristics. viagra online without prescription Endocrinology. 146(9):3985-98. viagra side effects bleeding Cusimano md, kovacs k, bilbao jm, tucker ws, singer w (1988) suprasellar craniopharyngioma associated with hyperprolactinemia, pituitary lactotroph hyperplasia, and microprolactinoma. Case report. generic viagra canada J neurosurg. 69(4):620-3. Kontogeorgos g, mourouti g, kyrodimou e, liapi-avgeri g, parasi e (2006) ganglion cell containing pituitary adenomas: signs of neuronal differentiation in adenoma cells. viagra response time Acta neuropathol (berl). 112(1):21-8. Luse sa, kernohan jw (1955) squamous-cell nests of the pituitary gland. Cancer. viagra online 8(3):623-8.. We will provide
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