Endocrinologically Incomplete Transethmoidal Trans-Sphenoidal Hypophysectomy with Relief of Bone Pain in Breast Cancer
- 15 June 1978
- journal article
- research article
- Published by Massachusetts Medical Society in New England Journal of Medicine
- Vol. 298 (24), 1332-1335
- https://doi.org/10.1056/nejm197806152982403
Abstract
To assess endocrinologic completeness of transethmoidal trans-sphenoidal hypophysectomy and the relation between postoperative pituitary hormone levels and relief of bone pain, we tested pituitary reserve by measuring base-line values of follicle-stimulating hormone and luteinizing hormone, thyrotropin-releasing-factor-stimulated thyrotropin and prolactin, and levodopa-stimulated growth hormone after hypophysectomy in 15 menopausal women with metastatic breast cancer. In all 15 bone pain diminished or disappeared within 24 hours of operation. Pituitary-function testing identified only one patient as having had an endocrinologically complete hypophysectomy. Base-line gonadotropin levels and thyrotropin-releasing-factor-stimulated prolactin were the most reliable measures of residual pituitary function. We conclude that transethmoidal trans-sphenoidal hypophysectomy may not totally ablate pituitary endocrine function; effective relief of bone pain in patients with metastatic breast cancer can follow this procedure despite residual pituitary function and the lack of objective tumor remission. (N Engl J Med 298:1332–1335, 1978)This publication has 15 references indexed in Scilit:
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