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• W2116857156 abstract "In 1958, Nelson et al. (13) first described an ACTH-secreting chromophobe adenoma after bilateral adrenalectomy in a patient with Cushing's syndrome. Since that time other cases in which previously unsuspected pituitary tumors became manifest after adrenalectomy have been reported (1–3, 5, 6, 8, 9, 11, 14, 15, 17). In these, the pituitary tumor was diagnosed in from one to ten years after adrenalectomy. Most of the patients were women, reflecting the predilection of Cushing's syndrome for females. The pituitary tumors in these patients were chromophobe adenomas, basophil adenomas, or mixed basophil and chromophobe adenomas, and carcinomas composed of either basophilic or chromophobic components. Cushing's syndrome resulting from adrenocortical hyperfunction is frequently treated by bilateral total or subtotal adrenalectomy. Since it has become apparent that in some of these patients evidence of pituitary tumor may develop after adrenalectomy, routine follow-up roentgenograms are essential. Report of Cases Case I: This man was one of several patients reported by Nelson et al. (14). When he was twenty-four, a bilateral adrenalectomy was performed for Cushing's syndrome. Visual fields and roentgenograms of the sella were normal at that time (Fig. 1). After the adrenalectomy, pigmentation of the skin became apparent. Three years later, in 1958, enlargement of the sella turcica was noted, and the pituitary was subsequently irradiated. Despite persistence of the abnormal pigmentation, the patient was asymptomatic. In 1962, seven years after adrenalectomy and four years after pituitary irradiation, the sella had enlarged further (Fig. 2). The enlargement was even more marked in 1965 (Fig. 3). At that time pneumoencephalography showed suprasellar extension of the pituitary tumor (Fig. 4), although there was no visual field loss. In addition, a soft-tissue mass was seen to extend downward into the sphenoid sinus (Fig. 5). In November 1965 the sphenoid extension of the tumor was removed surgically. The histologic diagnosis was “pituitary adenoma, corticotrophic cell type” (basophil adenoma). Case II: A 32-year-old woman was admitted to the University of California Medical Center in June 1966 because of enlargement of the sella turcica (Fig. 6). Eight years earlier Cushing's syndrome had required a bilateral adrenalectomy. Roentgenograms of the skull at that time were said to have shown no abnormality. A few months after adrenalectomy, increasing pigmentation of the skin had been noted. Visual fields at the time of admission were normal. A pneumoencephalogram gave no evidence of suprasellar extension. In October 1966, an hypophysectomy was performed through a transsphenoid approach. The histologic diagnosis was basophilic adenoma of the pituitary gland. Case III: A 33-year-old woman underwent bilateral adrenalectomy for Cushing's syndrome in early 1959. Roentgenograms of the skull disclosed no abnormalities, and the visual fields were normal at that time." @default.
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• W2116857156 date "1968-02-01" @default.
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• W2116857156 title "Roentgen Aspects of Pituitary Tumors Manifested after Bilateral Adrenalectomy for Cushing's Syndrome" @default.
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• W2116857156 doi "https://doi.org/10.1148/90.2.276" @default.
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