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with a pituitary adenoma in a patient not given radiotherapy) and one case of glioma (which was paralleled by a glioma in a contemporaneous patient with Cushing's syndrome who was not given radiotherapy). The apparent disparity between these figures and those of Brada and colleagues emphasises the rarity of these second tumours and the difficulty of interpreting small numbers, particularly in the absence of a control series. Sellar fibrosarcoma, glioma, and meningioma are distinct and disparate pathological processes, each with its own propensity for development under the influence of radiation, and it is probably not justifiable to amalgamate them in an attempt to increase total numbers. Moreover, improvements in diagnostic techniques and accuracy have meant that the rate of pituitary adenoma and meningioma, occurring either together or separately, is difficult to compare with rates in earlier series. Brada and colleagues' series of 334 patients was selected from 436 patients (102 having been excluded), which may affect its validity. On the basis of their data the authors suggest a guideline of an excess of 2-4 brain tumours in 100 patients so treated and followed up for 20 years. The series at St Bartholomew's Hospital and that of Brada and colleagues are among the largest series of patients receiving megavoltage irradiation for pituitary adenomas to date, and each has taken over 20 years to accrue; the patterns of oncogenesis in even these two large series emphasise that such second brain tumours are rare, and their true incidence could be obtained only from larger experience. On present evidence we consider that the suggested guideline regarding the risks of therapy is unwarranted. Earlier studies showed clearly that without external beam radiotherapy there is a high rate of recurrence (up to 80% by 10 years) in patients with macroadenomas after surgery.' Pituitary radiation protects against this most efficiently and remains a valuable treatment for both functioning and nonfunctioning tumours. J A H WASS

Videotaped interviews with children suspected of being sexually abused.