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General Considerations in the Surgical Treatment of Pituitary Tumors

  • Kalmon D. Post

Abstract

In 1886, Marie1 suggested a relationship between acromegaly and pituitary tumors. By 1893, Caton and Paul2 reported an attempt at removal of a growth hormone (GH)-producing tumor via craniotomy and middle fossa approach. In 1905, Krause3 suggested an approach through the anterior cranial fossa, and in 1906, Sir Victor Horsley4 reported on 10 cases approached via the middle fossa. The techniques were crude and visibility poor; alternative routes were sought. The first extracranial transsphenoidal procedure was probably that by Schloffer5 in 1907, although Giordano6 had suggested a transsinus approach in 1897. Cushing7 began using a transsphenoidal approach in 1909, and thereafter performed over 200 cases via this route. Until then, the operation involved considerable dissection of the frontal sinus, nose, ethmoids, and sphenoids and was very disfiguring. In 1910, Halstead8 performed surgery through a transoronasal route with an incision through the mucosa above the upper teeth, utilizing the submucosal techniques of Kocher.9 In 1910, Oscar Hirsch10 did the first of 413 transsphenoidal procedures,1112 and introduced Harvey Cushing to the procedure. Cushing’s reputation attracted many patients, and within several years he had performed over 100 cases.13

Keywords

Pituitary Adenoma Pituitary Tumor Transsphenoidal Surgery Pituitary Apoplexy Normal Gland 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    P. Marie, Sur deux cas d’acromegalie: Hypertrophie singuliere, non congenitale, des extremities superieures, inferieure et cephalique, Rev. Med. (Paris) 6:297–333, 1886.Google Scholar
  2. 2.
    R. Caton and F.T. Paul, Notes of a case of acromegaly treated by operation, Br. Med. J. 2:1421–1432, 1893.PubMedCrossRefGoogle Scholar
  3. 3.
    F. Krause, Hirnchirurgie, Dtsch. Klin. 8:953–1024, 1905.Google Scholar
  4. 4.
    V. Horsley, On the technique of operation on the central nervous system, Br. Med. J. 2:411, 1906.CrossRefGoogle Scholar
  5. 5.
    H. Schloffer, Erfolgreiche Operation eines Hypophysecentumors auf nasalem Wege, Wien. Klin. Wochenschr. 20:621–624, 1907.Google Scholar
  6. 6.
    F. Giordano, Compendio Chir. Operat. Ital. 2:100, 1897 (quoted by G.J. Heuer, The surgical approach and the treatment of tumors and other lesions about the optic chiasm, Surg. Gynecol. Obstet 53:489–518, 1931).Google Scholar
  7. 7.
    H. Cushing, Partial hypophysectomy for acromegaly with remarks on the function of the hypophysis, Ann. Surg. 50:1002–1017, 1909.PubMedCrossRefGoogle Scholar
  8. 8.
    A.E. Halstead, Remarks on the operative treatment of tumors of the hypophysis, with the report of two cases operated on by an oro-nasal method, Surg. Gynecol. Obstet. 10:494–502, 1910.Google Scholar
  9. 9.
    T. Kocher, Die Verletzungen der Wirbelsäule zugleich als Beitrag zur Physiologie des menschlichen Ruckenmarks Mitt a.d., Grenzgeb. Med. Chir. 1:415–580, 1896.Google Scholar
  10. 10.
    O. Hirsch, Endonasal method of removal of hypophyseal tumours: With report of two cases, J. Am. Med. Assoc. 55:772, 1910.CrossRefGoogle Scholar
  11. 11.
    O. Hirsch, Pituitary tumours: A borderland between cranial and trans-sphenoidal surgery, N. Eng. J. Med. 254:937–939, 1954.CrossRefGoogle Scholar
  12. 12.
    O. Hirsch, Life-long cures and improvements after trans-sphenoidal operation of pituitary tumours (thirty-three patients followed for 20–37 years), Acta Ophthalmol. (Copenhagen) Suppl. 56:60, 1959.Google Scholar
  13. 13.
    H. Cushing, Surgical experiences with pituitary disorders, J. Am. Med. Assoc. 63:1515–1525, 1914.CrossRefGoogle Scholar
  14. 14.
    C.H. Frazier, An approach to the hypophysis through the anterior cranial fossa, Ann. Surg. 57:145–150, 1913.PubMedCrossRefGoogle Scholar
  15. 15.
    C.H. Frazier and F.C. Grant, Pituitary disorder, a digest of 100 cases, with remarks on the surgical treatment, J. Am. Med. Assoc. 85:1103–1106, 1925.CrossRefGoogle Scholar
  16. 16.
    H. Cushing, The Pituitary Body and Its Disorders: Clinical States Produced By Disorders of the Hypophysis Cerebri, p. 341, J.B. Lippincott, Philadelphia, 1912.Google Scholar
  17. 17.
    H. Cushing, Intracranial Tumors: Notes upon a Series of Two Thousand Verified Cases with Surgical-Mortality Percentages Pertaining Thereto, Charles C. Thomas, p. 150, Springfield, Illinois, 1932.Google Scholar
  18. 18.
    W.R. Henderson, The pituitary adenomata: Follow-up study of surgical results in 338 cases (Dr. Harvey Cushing’s series), Br. J. Surg. 26:811–921, 1939.CrossRefGoogle Scholar
  19. 19.
    H.C. Johnson, Surgery of the hypophysis, in: A History of Neurological Surgery (W.E. Walker, ed.), pp. 152–177, Hafner, New York, 1967.Google Scholar
  20. 20.
    E.C. Kendall, Some observations on the hormone of the adrenal cortex designated Compound E, Mayo Clin. Proc. 24:298, 1949.Google Scholar
  21. 21.
    G. Guiot and B. Thibaut, L’extirpation des adenomes hypophysares par voie transsphenoidale, Neuro-Chirur. (Stuttgart) 1:133, 1959.Google Scholar
  22. 22.
    J. Hardy, Microsurgery Applied to Neurosurgery (M.G. Yasargil, ed.), pp. 180–193, Academic Press, New York, 1969.Google Scholar
  23. 23.
    J. Hardy, A. Panisset, A. Marchildon, and A. Lanthier, Microsurgical selective anterior pituitary ablation for diabetic retinopathy, Can. Med. Assoc. J. 100:785–792, 1969.PubMedGoogle Scholar
  24. 24.
    L.I. Malis, Bipolar coagulation in microsurgery, in: Microsurgery Applied to Neurosurgery (M.G. Yasargil, ed.), pp. 41–45, Academic Press, New York, 1969.Google Scholar
  25. 25.
    C.H. Chang and J.L. Pool, The radiotherapy of pituitary chromophobe adenomas, Radiology 89:1005, 1967.PubMedGoogle Scholar
  26. 26.
    L.M. Davidoff, Symposium on pituitary tumours. IV. Discussion of papers, J. Neurosurg. 19:22, 1962.CrossRefGoogle Scholar
  27. 27.
    R.T. Costello, Subclinical adenoma of the pituitary gland, Am. J. Pathol. 12:205–215, 1936.PubMedGoogle Scholar
  28. 28.
    J.W. Kernohan and G.P. Sayre, Tumors of the pituitary gland and infundibulum, in: Atlas of Tumor Pathology, 1st Series, Fascicle 36, Armed Forces Institute of Pathology, Washington, D.C., 1956.Google Scholar
  29. 29.
    G.E. Sheline, Comment in discussion, in: Diagnosis and Treatment of Pituitary Tumors (P.O. Kohler and G.T. Ross, eds.), pp. 157–158, Excerpta Medica, Amsterdam, 1973.Google Scholar
  30. 30.
    J.B. Tyrrell, R.M. Brooks, P.A. Fitzgerald, P.B. Cofoid, P.H. Forsham, and C.B. Wilson, Cushing’s disease: Selective trans-sphenoidal resection of pituitary microadenomas, N. Engl. J. Med. 298(14):753–758, 1978.PubMedCrossRefGoogle Scholar
  31. 31.
    W.H. Daughaday, Cushing’s disease and basophilic microadenomas (editorial), N. Engl. J. Med. 298(14):793, 1978.PubMedCrossRefGoogle Scholar
  32. 32.
    R.M. Salassa, E.R. Laws, Jr., P.C. Carpenter, and R.C. Northcutt, Transsphenoidal removal of pituitary midroadenoma in Cushing’s disease, Mayo Clin. Proc. 53:24–28, 1978.PubMedGoogle Scholar
  33. 33.
    D.P. MacErlean and F.H. Doyle, The pituitary fossa in Cushing’s syndrome: A retrospective analysis of 93 patients, Br. J. Radiol. 49:820–826, 1976.PubMedCrossRefGoogle Scholar
  34. 34.
    R.M. Salassa, T.P. Kearns, J.W. Kernohan, et al., Pituitary tumors in patients with Cushing’s syndrome, J. Clin. Endocrinol. Metab. 19:1523–1539, 1959.PubMedCrossRefGoogle Scholar
  35. 35.
    T.J. Moore, R.G. Dluhy, G.H. Williams, and J.P. Cain, Nelson’s syndrome: Frequency, prognosis, and effect of prior pituitary irradiation, Ann. Intern. Med. 85(6):731–734, 1976.PubMedGoogle Scholar
  36. 36.
    A.S. Jennings, G.W. Liddle, and D.N. Orth, Results of treating childhood Cushing’s disease with pituitary irradiation, N. Engl. J. Med. 297(18):957–962, 1977.PubMedCrossRefGoogle Scholar
  37. 37.
    D.N. Orth and G.W. Liddle, Results of treatment in 108 patients with Cushing’s syndrome, N. Engl. J. Med. 285:243, 1971.PubMedCrossRefGoogle Scholar
  38. 38.
    F.C. Dohan, A. Raventos, N. Boucot, and E. Rose, Roentgen therapy in Cushing’s syndrome without adrenocortical tumor, J. Clin. Endocrinol. Metab. 17:8, 1957.PubMedCrossRefGoogle Scholar
  39. 39.
    A.D. Wright, D.M. Hill, C. Lowy, and T.R. Fraser, Mortality in acromegaly, Q. J. Med. 39:1–16, 1970.PubMedGoogle Scholar
  40. 40.
    J. Roth, P. Gorden, and K. Brace, Efficacy of conventional pituitary irradiation in acromegaly, N. Engl. J. Med. 282(25):1385–1391, 1970.PubMedCrossRefGoogle Scholar
  41. 41.
    J.F. Aloia, M.S. Roginsky, and J.O. Archambeau, Pituitary irradiation in acromegaly, Am. J. Med. Sci. 267(2):81–87, 1974.PubMedCrossRefGoogle Scholar
  42. 42.
    R.N. Kjellberg, A. Shintani, A.G. Frantz, and B. Kliman, Proton-beam therapy in acromegaly, N. Engl. J. Med. 278(13):690–695, 1968.CrossRefGoogle Scholar
  43. 43.
    R.N. Kjellberg and B. Kliman, Radiosurgery therapy for pituitary adenoma, Presented at a Symposium on Pituitary Tumors, Tufts—New England Medical Center, Boston, Massachusetts, April 5, 1978.Google Scholar
  44. 44.
    M.E. Molitch, Medical therapy of pituitary tumors, in: The Pituitary Adenoma (K.D. Post, I.M.D. Jackson, and S. Reichlin, eds.), Plenum Press, New York, 1980.Google Scholar
  45. 45.
    S. Franks, H.S. Jacobs, and J.D.N. Nabarro, Studies of prolactin in pituitary disease, J. Endocrinol. 67:55, 1977.Google Scholar
  46. 46.
    J.L. Antunes, E.M. Housepian, A.G. Frantz, D.A. Holub, R.M. Hui, P.W. Carmel, and D.O. Quest, Prolactin-secreting pituitary tumors, Ann. Neurol. 2:148–153, 1977.CrossRefGoogle Scholar
  47. 47.
    J. Hardy, Clinical Neurosurgery p. 16, Williams and Wilkins, Baltimore, 1969.Google Scholar
  48. 48.
    J. Hardy, Trans-sphenoidal microsurgical removal of pituitary adenoma, in: Recent Progress in Neurological Surgery, p. 86, Excerpta Medica, Amsterdam, 1974.Google Scholar
  49. 49.
    J.N. Carter, J.E. Tyson, G. Tolis, S. Van Vliet, C. Faiman, and H.G. Friesen, Prolactin-secreting tumors and hypogonadism in 22 men, N. Engl. J. Med. 299(16):847–852, 1978.PubMedCrossRefGoogle Scholar
  50. 50.
    S.M. Wolpert, The radiology of pituitary adenomas—an update, in: The Pituitary Adenoma (K.D. Post, I.M.D. Jackson, and S. Reichlin, eds.), Plenum Press, New York, 1980.Google Scholar
  51. 51.
    J.L. Vezina and S.J. Tudor, Prolactin-secreting pituitary microadenomas: Roentgenologic diagnosis, Am. J. Roentgenol. Radium Ther. Nucl. Med. 120:46–54, 1974.PubMedGoogle Scholar
  52. 52.
    R.F. Spark, J. Pallotta, F. Naftolin, and R. Clemens, Galactorrhea—amenorrhea syndromes: Etiology and treatment, Ann. Intern. Med. 84:532–537, 1976.PubMedGoogle Scholar
  53. 53.
    M.O. Thorner, A.S. McNeilly, C. Hagan, and G.M. Besser, Long-term treatment of galactorrhea and hypogonadism with bromocriptine, Br. Med. J. 2:419–422, 1974.PubMedCrossRefGoogle Scholar
  54. 54.
    E. Del Pozo, L. Varga, H. Wyss, G. Tolis, H. Friesen, R. Wenner, L. Vetter, and A. Uettwiler, Clinical and hormonal response to bromocriptine (CB 154) in the galactorrhea syndromes, J. Clin. Endocrinol. Metab. 39:18–26, 1974.PubMedCrossRefGoogle Scholar
  55. 55.
    M.A. Galconer and M.A. Stafford-Bell, Visual failure from pituitary and parasellar tumours occurring with favourable outcome in pregnant women, J. Neurol. Neurosurg. Psychiatry 38:914–930, 1975.Google Scholar
  56. 56.
    P.B. Nelson, A.G. Robinson, D.F. Archer, and J.C. Maroon, Symptomatic pituitary tumor enlargement after induced pregnancy: Case report, J. Neurosurg. 49:283–287, 1978.PubMedCrossRefGoogle Scholar
  57. 57.
    M.D. Thorner, G.M. Besser, A. Jones, J. Daice, A.E. Jones, and C.N. Shealy, Bromocriptine treatment of female infertility: Report of 13 pregnancies, Br. Med. J. 4:694–697, 1975.PubMedCrossRefGoogle Scholar
  58. 58.
    R.H. Wiebe, C.B. Hammond, and S. Handwerger, Treatment of functional amenorrhea—galactorrhea with 2-bromoergocryptine, Fertil. Steril. 28:426–433, 1977.PubMedGoogle Scholar
  59. 59.
    J.T.W. Van Dalen and E.L. Greve, Rapid deterioration of visual fields during bromocriptine-induced pregnancy in a patient with a pituitary adenoma, Br. J. Ophthalmol. 61(2):729–733, 1977.PubMedCrossRefGoogle Scholar
  60. 60.
    K.D. Post, B.J. Biller, L.S. Adelman, M.E. Molitch, S.M. Wolpert, and S. Reichlin, Results of selective transsphenoidal adenomectomy in women with galactorrhea—amenorrhea, J. Am. Med. Assoc. 242(2):158–162. 1979.CrossRefGoogle Scholar
  61. 61.
    B. Corenblum, B.R. Webster, C.B. Mortimer, and C. Ezrin, Possible antitumour effect of bromocriptine in two patients with large prolactin-secreting pituitary adenomas, Clin. Res. 34:614, 1975 (abstract).Google Scholar
  62. 62.
    A.M. McGregor, M.F. Scanlon, and K. Hall, Reduction in size of a pituitary tumor by bromocriptine therapy, N. Engl. J. Med. 300:291–293, 1979.PubMedCrossRefGoogle Scholar
  63. 63.
    K.D. Post and D.L. Kasdon, Sellar and parasellar lesions mimicking adenoma, in: The Pituitary Adenoma (K.D. Post, I.M.D. Jackson, and S. Reichlin, eds.), Plenum Press, New York, 1980.Google Scholar
  64. 64.
    C.S. McLanahan, J.H. Christy, and G.T. Tindall, Anterior pituitary function before and after trans-sphenoidal microsurgical resection of pituitary tumors, Neurosurgery 3(2): 142–145, 1978.CrossRefGoogle Scholar
  65. 65.
    G. Guiot, Transsphenoidal approach in surgical treatment of pituitary adenomas: General principles and indications in non-functioning adenomas, in: Diagnosis and Treatment of Pituitary Tumors (P.O. Kohler and G.T. Ross, eds.), pp. 159–178, Excerpta Medica, Amsterdam, 1973.Google Scholar
  66. 66.
    L.S. Adelman and K.D. Post, Intraoperative frozen section technique for pituitary adenomas, Am. J. Surg. Pathol, February, 1979.Google Scholar
  67. 67.
    B.S. Ray and R.H. Patterson, Symposium on pituitary tumors. 1. Surgical treatment of pituitary adenomas, J. Neurosurg. 19:1, 1962.PubMedCrossRefGoogle Scholar
  68. 68.
    B.S. Ray and R.H. Patterson, Surgical experience with chromophobe adenomas of the pituitary gland, J. Neurosurg. 34:726, 1971.PubMedCrossRefGoogle Scholar
  69. 69.
    H.J. Svien and M.Y. Colby, Pituitary chromophobe adenomas: Comparative results of surgical and roentgen treatment, Behav. Neurol. 1:35, 1969.Google Scholar
  70. 70.
    T.P. Hayes, R.A. Davis, and A. Raventos, The treatment of pituitary chromophobe adenomas, Radiology 98:149, 1971.PubMedGoogle Scholar
  71. 71.
    S.G. Elington and W. McKissock, Pituitary adenomata: Results of combined surgery and radiotherapeutic treatment of 260 patients, Br. Med. J. 1:263, 1967.CrossRefGoogle Scholar
  72. 72.
    G.E. Sheline, E.B. Boldrey, and T.L. Phillips, Chromophobe adenomas of the pituitary gland, Am. J. Roentgenol. 92:160, 1964.Google Scholar
  73. 73.
    S.B. Heimbach, Étude uivie de 105 cas d’adenomes chromophobes et acidophiles de l’hypophyse, dument verifies apres traitement par operation transfrontale et radiotherapie (Krayenbuhl’s series), Acta Neurochir. (Vienna) 7:101, 1959.CrossRefGoogle Scholar
  74. 74.
    J.I. Neurnberger and S.R. Korey, Pituitary Chromophobe Adenomas, Springer-Verlag, New York, 1953.Google Scholar
  75. 75.
    W. Tonnis, D. Oberdisse, and F. Weber, Bericht über 264 operierte Hypophysenadenome, Acta Neurochir. (Vienna) 2(3):133, 1952.Google Scholar
  76. 76.
    J. Hardy, Transsphenoidal surgery of hypersecreting pituitary tumors, in: Diagnosis and Treatment of Pituitary Tumors (P.O. Kohler and G.T. Ross, eds.), pp. 170–194, Excerpta Medica, Amsterdan, 1973.Google Scholar
  77. 77.
    J. Hardy and J.L. Vezina, Transsphenoidal neurosurgery of intracranial neoplasm, in: Advances in Neurology (R.A. Thompson and J.R. Green, eds.), pp. 261–274, Raven Press, New York, 1976.Google Scholar
  78. 78.
    P. Demailly, G. Guiot, and A. Oproiu, Resultats visuels des exereses d’adenomes hypophysaires par voie transsphenoidale, Arch. Ophthalmol. (Paris) 27:5, 1967.Google Scholar
  79. 79.
    N. Zervas and G. Mendelson, Treatment of acute hemorrhage of pituitary tumors, Lancet 1:604, 1975.PubMedCrossRefGoogle Scholar

Copyright information

© Plenum Publishing Corporation 1980

Authors and Affiliations

  • Kalmon D. Post
    • 1
    • 2
  1. 1.Tufts University School of MedicineBostonUSA
  2. 2.Department of NeurosurgeryTufts-New England Medical Center HospitalBostonUSA

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