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Rolf Luft and Herbert Olivecrona

pituitary fossa revealed small rests of regenerating glandular tissue ( Fig. 11 ). Fig. 11. Section of the pituitary fossa 3½ months after hypophysectomy for prostatic cancer. Small rests of pituitary tissue are still present. In a case of hypernephroma with numerous metastases to the lung, hypophysectomy was well tolerated. However, the adrenalin test indicated that removal was probably not complete. It has not been possible to reexamine the patient, as she lives in another country. The latest report received 3 months after operation indicated

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George Ehni and Nylene E. Eckles

necrosis of the anterior pituitary gland described by Sheehan 24 was the result of obstruction by thrombosis of the portal vessels in the stalk and lower infundibular stem. It was, of course, this very result that we hoped to attain for our patients. Most importantly, there was the personal experience of one of us in producing an intense hypopituitary state in a male patient of Dr. J. B. Trunnell with prostatic cancer who was subjected to pituitary-stalk interruption on December 7, 1955 (before the series here reported was begun) at the suggestion of Drs. Claude

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Bronson S. Ray

hypophysectomy have resulted in a preponderance of such cases. It is disappointing to report that the operation has not proved beneficial for cancer other than that of the breast, of the prostate and possibly of the thyroid. In two of four thyroid cases there appears to be benefit, but because of the slow growth of the tumor evaluation must be made cautiously. Of 16 patients with prostatic cancer all had far advanced disease and had already received most of the forms of treatment commonly employed, yet six of the number were benefited by hypophysectomy. There are similarities

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Bronson S. Ray

Edited by Eben Alexander Jr.

T otal removal of the pituitary in man became feasible when the resulting hypoadrenalism could be controlled by ACTH or cortisone that was made available in the early 1950's. Since then, hypophysectomy has come to have a valuable place as an elective palliative procedure in selected cases of mammary cancer, prostatic cancer, and diabetic retinopathy. It has a useful place also in the treatment of uncontrolled acromegaly, recurrent chromophobe adenoma, and Cushing's disease. Although there are alternate methods of removing or ablating the pituitary, the

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Ruben J. Saez, R. Jean Campbell and Edward R. Laws Jr.

myxofibrosarcoma in organ culture and observed a decreased uptake of radioactive tracer in treated cultures. In 1972, McMahon, et al. , 23 studied the morphological response of prostatic adenocarcinoma in organ culture to testosterone and noted greater cellular differentiation in one case and an increased number of mitotic figures in another; no changes were noted in the presence of stilbestrol. They concluded that the technique deserved further study because it might suggest more adequate choices of hormonal therapy against prostatic cancer. This paper reports our

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Michael Feely and Marta Steinberg

Aspergillus fumigatus . Report of a case. Arch Surg 26: 99–109, 1933 2. Coe GC : Primary bronchopulmonary aspergillosis, an occupational disease. Ann Intern Med 23 : 423 – 425 , 1945 Coe GC: Primary bronchopulmonary aspergillosis, an occupational disease. Ann Intern Med 23: 423–425, 1945 3. Fergusson JD : Implantation of radioactive material into the pituitary for the control of prostatic cancer. An interim review. Br J Urol 29 : 215 – 221 , 1957 Fergusson JD: Implantation of radioactive material

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Shigeharu Suzuki, Kenjiro Ito and Takashi Iwabuchi

) 10 ventricular cannula no 10 flushing reservoir no improved 11 74 M intractable pain (prostatic cancer) 4 ventricular cannula no improved 12 6 M spinal cord tumor 15 ventricular cannula no improved 13 27 M posterior fossa arachnoiditis 12 cisternal puncture no improved In spite of its favorable diffusibility, since Amipaque tends to sink in CSF due to its greater density (1.184 gm/ml, 37° C), the patient should be positioned so that the region to be visualized is lower than

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George T. Tindall, Nettleton S. Payne and Daniel W. Nixon

and prostate gland. 7, 18, 28, 30, 32–35 Initially, hypophysectomy was performed by a transcranial approach and, while definite therapeutic benefits were obtained, some physicians believed that craniotomy was too major a procedure for many patients with advanced breast and prostatic cancer. For this reason, many individuals who would otherwise have been good candidates for hypophysectomy were not advised to undergo the operation. Fortunately, easier and safer methods for accomplishing hypophysectomy such as stereotaxic cryohypophysectomy, 26 stereotaxic

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The single supratentorial lesion

An evaluation of preoperative diagnostic tests

Rand M. Voorhies, Narayan Sundaresan and H. Tzvi Thaler

and in deciding the most appropriate therapy for the patient. Even in this group, there is a small chance that a second primary tumor or non-neoplastic lesion will be found. In our series, two patients with breast cancer were found to have meningiomas. One patient with lung cancer was found to have a small angiomatous malformation, and a fourth patient with prostate cancer was found to have a glioblastoma. Our purpose is not to lay down rigid criteria for the performance of diagnostic tests, since such inflexible attitudes may hinder the management of any one

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Avoidance of diabetes insipidus in transsphenoidal hypophysectomy

A modified technique of selective hypophysectomy

Toussaint A. Leclercq and Francois Grisoli

complication of hypophysectomy, should further tilt the balance of opinion in favor of hypophysectomy when an ablative palliative procedure is considered necessary. References 1. Brendler H : Adrenalectomy and hypophysectomy for prostatic cancer. Urology 2 : 99 – 102 , 1973 Brendler H: Adrenalectomy and hypophysectomy for prostatic cancer. Urology 2: 99–102, 1973 2. Ehni G , Eckles NE : Interruption of the pituitary stalk in the patient with mammary cancer. J Neurosurg 16 : 628 – 652 , 1959