Abstract
ABSTRACT Pituitary stalk section was performed in 26 women with rapidly advancing metastatic carcinoma of the breast. A tantalum plate was inserted above the sella to retard revascularization from the hypothalamus. Summarized results of detailed studies of adrenal function both before and after the operation are presented. Many of the patients excreted low or low-normal quantities of 17-ketosteroids and 17-hydroxycorticosteroids prior to surgery. Following the operation, steroid excretion gradually decreased to the low levels observed in hypopituitarism and characteristic symptoms of adrenal insufficiency developed. These symptoms were alleviated by the administration of ACTH or prednisolone. When substitution therapy was withheld, there was no tendency for urinary steroids to rise and symptoms of adrenal insufficiency recurred. The capacity of the pituitary-adrenal axis to respond to “stress” was assessed by measuring the rise in the concentration of plasma 17-hydroxycorticosteroids during an insulin-glu...
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