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An Evaluation of Dynamic Pituitary Function Tests in Patients with Pituitary Tumours
Author(s) -
Best J. D.,
Alford F. P.,
Chisholm D. J.,
Mowat P.,
Henderson K.,
Anderson R. McD.
Publication year - 1982
Publication title -
australian and new zealand journal of medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 0004-8291
DOI - 10.1111/j.1445-5994.1982.tb03803.x
Subject(s) - medicine , acromegaly , hormone , hypophysectomy , basal (medicine) , endocrinology , pituitary gland , hypothalamus , pituitary hormones , somatotropic cell , growth hormone , insulin
An evaluation of dynamic pituitary function tests in patients with pituitary tumours. J. D. Best, F. P. Alford, D. J. Chisholm, P. Mowat, K. Henderson and R. McD. Anderson, Aust. N.Z. J. Med. , 1982, 12, pp. 231–240. In a prospective study of 26 patients with macroadenoma of the pituitary (14 secretory and 12 non‐secretory), basal and stimulated pituitary hormone levels were used to detect hypothalamic dysfunction and to examine pituitary hormone secretion before and after hypophysectomy. Suprasellar tumour extension with hypothalamic compression occurred in 18 patients but was not consistently associated with hormonal tests indicative of hypothalamic dysfunction. In patients with secretory tumours, secretory activity was adequately assessed by basal hormone levels alone, which showed that surgery reduced hormone levels by a mean 85% in acromegaly and by a mean 55% in prolactinomas. Pre‐operatively, pituitary reserve of hormones not being hypersecreted was often normal, despite large tumour size and hypothalamic compression. Even after apparently complete pituitary removal at surgery, normal responses to stimulatory tests could sometimes be detected. Conventional dynamic tests are only of limited value in the assessment of hypothalamo‐pituitary dysfunction in patients with large pituitary tumours and should not be used indiscriminately in such individuals requiring surgery. Summary This study evaluated whether dynamic pituitary function tests are: (i) useful in assessing tumour size and the presence of hypothalamic compression; (ii) able to distinguish between tumour or hypothalamic dysfunction; (iii) useful in assessing hormonal functional status of residual pituitary tissue. The results clearly demonstrate that currently available tests do not contribute to the assessment of tumour size, the presence or otherwise of hypothalamic compression or dysfunction. The results do indicate, however, that they maybe useful in the assessment of residual pituitary function in the postoperative period. Future attention must be directed towards the development of newer tests 35 which might give more specific information on hypothalamic control of hormone secretion.