Surgical Treatment of Functioning Pituitary Adenoma

Abstract

Clinical and endocrinological studies in 30 patients with functioning pituitary adenoma were conducted with special reference rendered to the endocrinological results of treatment.
Twenty-one patients were with acromegaly, 5 with Cushing's syndrome and 4 with Forbes-Albright syndrome.
In the treatment of patients with acromegaly, early diagnosis (microadenoma) and transsphenoidal removal was emphasized in order to obtain endocrinological cure. In the treatment of advanced tumor or adenoma with marked fibrosis, radical hypophysectomy was recommended to patients with advanced hypertension and/or diabetes mellitus and to patients after climacterium.
In patients with pituitary-dependent Cushing's syndrome, even without sellar change and without evidence of pituitary tumor other than endocrinological evidences of pituitary dependency transsphenoidal surgical procedure should be the initial treatment of choice.
Forbes-Albright syndrome with or without sellar change or even without visual impairment should also be treated surgically as selective removal of microadenoma may result in cure with restoration of the normal pituitary function.
A brief comment was made on the etiology of the pituitary adenoma. The results were ambivalent as to whether hypothalamic or pituitary but, from the clinical point of view, the hypothalamic origin should not be overestimated. In the treatment of the functioning pituitary adenoma transsphenoidal surgical removal should be performed as an initial treatment.
Because of its benign and selective nature, endocrinological cure with preservation of normal pituitary function is promised in the cases with microadenoma.