Hostname: page-component-586b7cd67f-2plfb Total loading time: 0 Render date: 2024-11-28T15:23:02.587Z Has data issue: false hasContentIssue false
  • English
  • Français

Pathological Diversity in Clinical Syndromes of Pituitary Hypersecretion: Its Significance in Evaluating their Surgical Treatment

Published online by Cambridge University Press:  18 September 2015

Harley S. Smyth
Harley S. Smyth*
Affiliation:
Division of Neurosurgery, The Wellesley Hospital, University of Toronto
*
The Wellesley Hospital of the 160 Wellesley St. E., Room 113, Toronto, Ontario, Ontario M4Y 1J3
Rights & Permissions [Opens in a new window]

Abstract:

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Thorough pathological examination disclosed considerable diversity of abnormal cell types and correspondingly different surgical correction rates among patients with apparently similar syndromes of pituitary hypersecretion.The surgical correction of acromegaly in patients with densely granulated growth hormone tumours was threefold that in patients whose tumours showed sparse granulation. Two non-prolactinoma tumour types associated with hyperprolactinemia have aggressive growth patterns; their special therapeutic management is discussed. Of 33 patients with Cushing's disease solitary adenomas were found in only 14, while six patients had proven corticotroph cell hyperplasia. Elective hypophysectomy should replace selective adenomectomy in selected cases of Cushing's disease.

Type
Research Article
Information
Canadian Journal of Neurological Sciences , Volume 12 , Issue S4 , November 1985 , pp. 358 - 362
Copyright
Copyright © Canadian Neurological Sciences Federation 1985

References

REFERENCES

1.Wilson, CB, Dempsey, LC. Transsphenoidal microsurgical removal of 250 pituitary adenomas. J Neurosurg 1978; 48: 13–22.CrossRefGoogle ScholarPubMed
2.Horvath, E, Kovacs, K, Killinger, DW, Smyth, HS, Weiss, MH, Ezrin, C. Mammosomatotroph cell adenoma of the human pituitary: a morphologic entity. Virchows Arch (Pathol Anat) 1983: 398: 277–289.CrossRefGoogle ScholarPubMed
3.Smyth, HS, Wong, M, Killinger, DW. Results of transsphenoidal microsurgery foracromegaly : correlation of radiologic, biochemical and ultrastructural features in 46 cases. Can J Neurol Sci 1982; 9, 265, (Abstr).Google Scholar
4.Laws, ER, Piepgras, DG, Randall, RV, Abboud, CF. Neurosurgical management of acromegaly. Results in 82 patients treated between 1972 and 1977. J Neurosurg 1979; 50: 454–461.CrossRefGoogle ScholarPubMed
5.Giovanelli, MA, Motti, E, Paracchi, A. Treatment of acromegaly by transsphenoidal microsurgery. J Neurosurg 1976; 44: 677–686.CrossRefGoogle ScholarPubMed
6.Hardy, J, Somma, M, Vezina, JL. Treatment of acromegaly: radiation or surgery? In: Morley, TP, ed. “Current Controversies in Neurosurgery.” Saunders, Philadelphia. 1976; pp. 377–391.Google Scholar
7.Tolis, G. Prolactin: Physiology and pathology. Hosp Pract 1980; 15: 85–95.CrossRefGoogle ScholarPubMed
8.Horvath, E, Kovacs, K, Singer, W, Smyth, HS, Killinger, DW, Ezrin, C, Weiss, MH. Acidophile stem cell adenoma of the human pituitary: clinicopathological analysis of 15 cases. Cancer 1981; 47: 761–771.3.0.CO;2-L>CrossRefGoogle Scholar
9.Horvath, E, Kovacs, K, Killinger, DW, Smyth, HS, Plans, ME, and Singer, W. Silent corticotropic adenomas of the human pituitary gland. A histologic, immunocytologic and ultrastructural study. Am J Pathol 1980; 98: 617–638.Google ScholarPubMed
10.Cushing, H. The basophil adenomas of the pituitary body and their clinical manifestations (pituitary basophilism). Bull John Hopkins Hosp 1932; 50: 137–195.Google Scholar
11.Hardy, J. Cushing’s disease: 50 years later. Can J Neurol Sci 1982; 9: 375–380.CrossRefGoogle ScholarPubMed
12.Boggan, JE, Tyrrell, JB, Wilson, CB. Transsphenoidal microsurgical management of Cushing’s disease. Report of 100 cases. J Neurosurg 1983; 59: 195–200.CrossRefGoogle ScholarPubMed
13.Smyth, HS, Horvath, E, Kovacs, K, Killinger, DW. “Pituitary Basophilism”: microsurgical observations on the pathogenesis of Cushing’s disease. Ann Roy Coll Phys Surg Canada 1984; 17, 309. (Abstr).Google Scholar
14.Lüdecke, D, Kautzky, R, Saeger, W, Schrader, D. Selective removal of hypersecreting pituitary adenomas? An analysis of endocrine function, operative and microscopical findings in 101 cases. Acta Neurochir 1976; 35: 27–42.CrossRefGoogle ScholarPubMed