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Requiem for Pituitary Surgery?

Richard F. Spark, MD; Richard Baker, MD; Don C. Bienfang, MD; Richard Bergland, MD

JAMA. 1982;247(3):311-316.

Abstract
Twelve patients with pituitary tumor whose prior treatment included surgery and radiotherapy in four, surgery alone in four, radiotherapy alone in one, and none in three were studied. Nine had hyperprolactinemia, two had elevated serum growth hormones, and one had no pituitary hormone excess. Visual field defects were present in six. All had pituitary-gonadal insufficiency manifested as impotence or amenorrhea. All were treated with bromocriptine, 7.5 to 25 mg daily, and followed up for eight to 27 ([unk] 15) months. Serum prolactin levels decreased to normal in seven of nine patients. Serum growth hormone values were normalized in both acromegalics. When hormone levels were reduced to normal, pituitary tumor size decreased. Vision was restored to normal in five of six patients, including one patient with pituitary tumor but no pituitary hormone excess. Bromocriptine corrects the physiological defects associated with pituitary tumors that have been incompletely treated with surgery, radiotherapy, or both and may be a useful primary treatment for patients with pituitary tumors.

(JAMA 1982;247:311-316)

Author Affiliations
From the Department of Medicine and Surgery, Beth Israel Hospital (Drs Spark and Bergland), the Department of Radiology, Lahey Clinic (Dr Baker), and the Department of Ophthalmology, Brigham and Women's Hospital (Dr Bienfang), Boston.

Footnotes
Presented in part at the 50th annual meeting of the American Association of Neurologic Surgeons, Boston, April 7, 1981.

Reprint requests to the Steroid Research Laboratory, Beth Israel Hospital, 330 Brookline Ave, Boston, MA 02215 (Dr Spark).

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