Hypothalamo--pituitary--adrenal function in patients with suprasellar tumors (author's transl)

Abstract

Hypothalamo-pituitary-adrenal (H-P-A) function in 49 patients with suprasellar germinoma, craniopharyngioma, pituitary adenoma, tuberculum sellae meningioma, and other parasellar tumors was investigated. Plasma cortisol and urinary 17-OHCS were evaluated in basal conditions and after the following tests: ACTH, lysinevasopressin, insulin (hypoglycemia), and metopirone. Insulin test revealed that H-P-A function was impaired in 44.4% of suprasellar germinomas, 36.4% of craniopharyngiomas, 25.0% of pituitary adenomas, and 20% of tuberculum sellae meningiomas. After treatments, improvements of H-P-A function were observed generally, which probably reflected the improved surgical techniques using microscope. H-P-A function was normal when the tumor was confined in the sella turcica, and was first disturbed when tumors reached to the junction of hypothalamus and pituitary stalk or hypothalamus itself. However, the grade of H-P-A dysfunction was not correlated with the extension of tumors into the hypothalamus.