PRIMARY PITUITARY ADENOMA AND THE SYNDROME OF THE CAVERNOUS SINUS

Abstract

Through the brilliant labors of Cushing, Frazier and de Schweinitz, the signs and symptoms establishing the diagnostic criteria for primary pituitary adenoma have become familiar to every student. Of the classic triad of signs, the chiasmal syndrome, constitutional dyspituitarism and roentgen evidence of hypophysial disease, the first mentioned has played the largest role in the recognition of pituitary adenoma. Indeed, the preeminence of the visual component in the semiology of pituitary adenoma led Henderson,¹who recently published a critical review of Cushing's series of 338 cases, to declare : "It is exceptional for a chromophobe adenoma to be diagnosed or even suspected before it is sufficiently large to implicate the visual pathways. . . . operation would hardly be justified before vision is affected." This remark may be taken as the general opinion expressed by the many who have written on the diagnosis of pituitary adenoma. Though the nerves which supply the ocular