Transsphenoidal Adenectomy Research Articles

Adipose tissue and muscle volume determination by computed tomography in acromegaly, before and I year after adenomectomy

The adipose tissue volume, skeletal muscle and skin volume and visceral organ volume were determined using the multiscan CT (computed tomography) technique in 15 patients with acromegaly. The examinations were performed before treatment and 1 year after transsphenoidal adenectomy. The mean body weight did not change significantly after treatment; 91.3 kg and 92.3 kg pre and postoperatively in men and 66.7 kg and 65.9 kg in women respectively. The total adipose tissue volume increased by 7.11 (59.2%, P < 0.01) in the male group and 3.9 1 (20.3%, P < 0.05) in the female group. Muscle and skin mass and visceral organ mass decreased significantly after treatment. The muscle and skin mass decreased by 3.6 1 (-7.4%, P < 0.01) in males and by 3.2 1 in females (-11.5%, P < 0.02). The corresponding decrease in visceral organ mass was 1.5 1 (-17.0%, P < 0.01) in males and 1.0 1 (15.4%, P < 0.05) in females respectively. On average, the fractions of adipose tissue in the subcutaneous trunk and the intra-abdominal depots increased after treatment, while the fractions of adipose tissue in the limbs and the head and neck region decreased. The change in adipose tissue distribution pattern reached significance (P < 0.005) in men only.

Pulsatile secretory patterns of luteinizing hormone in two patients with secondary amenorrhea suffering from Cushing’s disease, before and after transsphenoidal adenectomy

In two infertile women with Cushing's disease, LH pulse frequency increased after pituitary adenectomy; both conceived within 4 months. This finding suggests that defective LH-RH-stimulation of LH secretion accounted (partially) for their infertility.

The effect of pregnancy on suspected pituitary adenomas after conservative management of ovulation defects associated with galactorrhea

Thirty intertile patients with ovulation defects and galactorrhea conceived after medical therapy: four after clomiphene stimulation (with or without hCG) and 26 after receiving CB-154 (2-Br-α-ergocryptine or bromergocryptine). Pregnancies were followed closely; sellar tomography and perimetry were repeated at 36 weeks' and 8 weeks' post partum. One patient required transsphenoidal adenectomy because of acute pituitary enlargement. Two developed minimal asymptomatic fossa enlargement. Lactation was suppressed with Lactostat in the first eight patients delivered; hyperprolactinemia, amenorrhea, and galactorrhea recurred. Five of eight showed asymptomatic enlargement of the sella. Bromergocryptine was used to suppress lactation in the rest. Long-term bromergocryptine therapy resulted in the restoration of euprolactinemic ovulatory cycles in all patients. These data suggest that patients with ovulation defects associated with galactorrhea can conceive with medical therapy now available. However, there is a risk of significant pituitary enlargement during pregnancy and the puerperium. Lactation should be suppressed with bromergocryptine.

Calcified Pituitary Tumor with Hyperprolactinemia: Selective Removal by Transsphenoidal Adenectomy

Calcified Pituitary Tumor with Hyperprolactinemia: Selective Removal by Transsphenoidal Adenectomy