Joseph Engel (1816–1899), author of a meaningful dissertation on tumors of the pituitary infundibulum: his report on the oldest preserved whole craniopharyngioma specimen

Abstract

Joseph Engel (1816–1899) was a Viennese anatomist and pathologist trained under the mentorship of Carl von Rokitansky (1804–1878), the man who laid the foundations of gross anatomical pathology. In 1839, Engel completed his first scientific project: the dissertation entitled “Über den Hirnanhang und den Trichter” (About the pituitary gland and the infundibulum). This work analyzed the pathological and clinical characteristics of the pituitary and infundibulum tumor specimens collected at the Vienna Pathologic-Anatomical Museum. This little-known work represents one of the earliest attempts to determine the function of the pituitary gland-infundibulum complex. Among the 12 pituitary/infundibulum tumors examined in Engel’s dissertation, one of the cases (no. 10) was instrumental for the definition of hypophyseal duct tumors, or craniopharyngiomas (CPs). This huge cyst, approximately the size of a goose egg (6 × 6 × 4.5 cm), was found in 1828 during the autopsy of a 33-year-old patient who suffered from severe headache, blindness, apathy, and finally somnolence. The cyst had replaced the hypophysis and extended upwards into the hypothalamic region and downwards into the sphenoid sinus, its inferior pole protruding through the soft palate. In 1904, the Viennese pathologist Jakob Erdheim (1874–1937) re-examined this lesion and conclusively categorized it as a hypophyseal duct tumor after a detailed histological study. The original tumor specimen corresponding to this CP case is still preserved at the Narrenturm, the circular building within the old Allgemeines Krankenhaus (Vienna General Hospital) that today holds the pathological collections of Vienna’s Federal Pathologic-Anatomical Museum. To the best of our knowledge, this tumor is very probably the oldest preserved whole CP specimen in the world. This paper presents a comprehensive review of Engel’s dissertation, the pioneering pathological work on pituitary and infundibulum tumors which laid the groundwork for the proper clinical, topographic, and pathological categorization of craniopharyngiomas.

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Abbreviations

CP:

Craniopharyngioma

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Acknowledgments

The authors wish to thank Crystal Smith and Liliya Gusakova, reference librarians of the Department of History of Medicine at the National Library of Medicine, National Institutes of Health, Bethesda, Maryland, for her kind assistance during the process of searching and retrieving articles and monographs used in this study. The authors are also indebted to the staff at the Francis Countway Medical Library at Harvard Medical School, Boston, Massachusetts, for their invaluable help in obtaining some of the original research material used for this study. We would especially like to express our acknowledgment to the staff in the Narrenturm and the Jakob Erdheim Institute for their kind assistance and the original pictorial material provided for this study. Finally, the authors wish to express their gratitude to George Hamilton for his critical review of the language and style of the manuscript.

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Conception and design: José M. Pascual; analysis and interpretation of data, writing, and editing the manuscript: José M. Pascual, Ruth Prieto, Maria Rosdolsky; material acquisition and investigation: Verena Hofecker, Eduard Winter, Sewan Strauss and Walter Ulrich. Critical review and approval of the manuscript: all authors.

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Correspondence to José M. Pascual.

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Pascual, J.M., Prieto, R., Rosdolsky, M. et al. Joseph Engel (1816–1899), author of a meaningful dissertation on tumors of the pituitary infundibulum: his report on the oldest preserved whole craniopharyngioma specimen. Virchows Arch 476, 773–782 (2020). https://doi.org/10.1007/s00428-019-02664-z

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Keywords

  • Carl Rokitansky
  • Craniopharyngioma
  • Hypothalamus
  • Joseph Engel
  • Jakob Erdheim
  • Infundibulum
  • Pituitary cyst
  • Pituitary gland