17-ketosteroids and Adenoma--Chromophobe

Pre- and postoperative visual and endocrine functions were examined in 54 patients with so-called chromophobe pituitary adenomas operated on by the transnasal approach. The preoperative examination showed visual disturbances in 41 of 48 patients. A loss of gonadal function was present in 93% of the women and 69% of the men. Impairment of adrenal function was found in 37% and of thyroid function in 18% of patients. Hyperprolactinemia was present in 16 of 29 patients examined. The visual findings remained unchanged, normal or improved in 75% of patients. Impairment occurred in 3%. Eight patients experienced improvement of gonadal function and 3 of adrenal function, whereas no postoperative improvement of the thyroid function was observed. Deterioration of gonadal function occurred in 4, of adrenal function in 7, and of thyroid function in 9 patients. Hyperprolactinemia was reduced in all cases.

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adenoma, Chromophobe; Adolescent; Adult; Aged; Erectile Dysfunction; Female; Humans; Male; Menstruation; Middle Aged; Pituitary Neoplasms; Prolactin; Thyroxine; Triiodothyronine; Visual Acuity; Visual Fields

A cyclic excess of cortisol secretion was detected in a patient with diabetes insipidus and diabetes mellitus. The cycles of hypercortisolism were of 7 days' duration, but during the nadir of these cycles urinary excretion of corticosteroids and 17-ketosteroids was within the normal range. The radiological appearance of the sella turcica was normal; however, computerized axial tomography of the head revealed a small tumor immediately superior to the sella turcica. At operation a small chromophobe adenoma superior to the diaphragma sellae and involving the hypophysial stalk was partially resected. Postoperatively, the patient continued to have 7-day cycles of increased corticosteroid excretion, but the amounts excreted were less than they had been preoperatively. Other patients have been described in whom Cushing's disease has been due to cyclic hypercortisolism. These cycles have been remarkably regular in individual patients, but of variable duration in different patients. Furthermore, cyclic hormonogenesis probably occurs in a variety of endocrinopathies. (Neurosurgery, 5: 598--603, 1979).

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adenoma, Chromophobe; Adrenal Cortex; Adult; Cushing Syndrome; Dexamethasone; Diabetes Insipidus; Humans; Hydrocortisone; Male; Periodicity; Pituitary Neoplasms; Vasopressins

The presenting signs, symptoms, roentgenographic findings, endocrine evaluations, treatment, and results in 68 cases of presumed pituitary adenomas treated over an 18-year period are discussed. The most common symptoms were headache, acromegalic changes, visual symptoms, and amenorrhea. Most common physical findings were obesity, acromegaly, and visual field defects, usually bitemporal hemianopsia. Roentgenographic evidence of sellar erosion was almost universal but angiography and pneumoencephalography were required to evaluate suprasellar extension. Brain scan was not considered a particularly useful diagnostic tool. Endocrine status was best evaluated by a battery of tests including 17-OH, 17-KS, T3, T4, PBI, ACTH stimulation, and FSH and STH levels. (Prolactin levels are currently being obtained, also). Surgical specimens were obtained in 29 patients, with subsequent diagnoses of 22 chromophobe adenomas, five eosinophilie adenomas, one cystic adenoma, and one necrotic tumor. All five eosinophilic tumors came from acromegalic patients. Patients treated by operation alone or operation followed by radiotherapy generally had less "medical morbidity" than did patients who received radiotherapy alone.

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Acromegaly; Adenoma; Adenoma, Acidophil; Adenoma, Chromophobe; Adolescent; Adult; Aged; Amenorrhea; Carotid Arteries; Female; Follow-Up Studies; Humans; Hypophysectomy; Male; Middle Aged; Neoplasm Recurrence, Local; Optic Atrophy; Pituitary Irradiation; Pituitary Neoplasms; Pneumoencephalography

Topics: 11-Hydroxycorticosteroids; 17-Hydroxycorticosteroids; 17-Ketosteroids; Adenoma, Chromophobe; Cortisone; Drinking; Ethanol; Growth Hormone; Humans; Hyponatremia; Hypopituitarism; Male; Middle Aged; Osmolar Concentration; Pituitary Neoplasms; Urination; Vasopressins

Topics: 17-Ketosteroids; Acromegaly; Adenoma, Chromophobe; Adult; Biopsy; Diagnosis, Differential; Humans; Male; Nasal Polyps; Nasopharynx; Pituitary Neoplasms; Radiography

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adenoma, Chromophobe; Adrenocorticotropic Hormone; Adult; Arginine; Blood Glucose; Craniopharyngioma; Diagnosis, Differential; Female; Glucose; Glucose Tolerance Test; Gonadotropins, Pituitary; Growth Hormone; Humans; Hypothalamo-Hypophyseal System; Insulin; Male; Metyrapone; Middle Aged; Pituitary Gland; Pituitary Hormones, Anterior; Pituitary Neoplasms; Pituitary-Adrenal System; Sella Turcica; Thyroid Gland; Vasopressins

Topics: 17-Ketosteroids; Adenoma, Chromophobe; Adult; Amenorrhea; Clomiphene; Estradiol; Estriol; Female; Gonadotropins; Humans; Infertility, Female; Pituitary Neoplasms; Pregnancy; Pregnancy Complications; Pregnancy in Diabetics; Radiography

Topics: 17-Ketosteroids; Adenoma, Chromophobe; Cushing Syndrome; Diabetic Nephropathies; Female; Heart Diseases; Humans; Hydrocortisone; Middle Aged; Pituitary Neoplasms

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adenoma, Chromophobe; Adult; Amenorrhea; Female; Follicle Stimulating Hormone; Humans; Lactation Disorders; Pituitary Function Tests; Pituitary Gland; Pituitary-Adrenal Function Tests; Pregnancy; Prolactin; Thyroid Function Tests

Topics: 17-Ketosteroids; Adenoma, Chromophobe; Aged; Blood Chemical Analysis; Carbutamide; Diabetes Mellitus; Humans; Hypophysectomy; Lipids; Male; Pituitary-Adrenal Function Tests

Topics: 17-Ketosteroids; Adenoma, Chromophobe; Adrenalectomy; Adult; Cushing Syndrome; Female; Humans; Pituitary Neoplasms

Topics: 17-Ketosteroids; Adenoma; Adenoma, Chromophobe; Adolescent; Adrenal Cortex Hormones; Adrenal Hyperplasia, Congenital; Adrenalectomy; Adrenocorticotropic Hormone; Adrenogenital Syndrome; Blood Chemical Analysis; Cushing Syndrome; Dexamethasone; Humans; Male; Progesterone; Testicular Neoplasms; Urine