Treatment of Nelson's Syndrome by Pituitary Implantation of Yttrium-90 or Gold-198

Overview

Journal Br Med J

Specialty General Medicine

Date 1976 Jul 31

PMID 182313

Citations 4

Authors

J Cassar

F H DOYLE

P D Lewis

K Mashiter

S Noorden

G F JOPLIN

Affiliations

Soon will be listed here.

Abstract

Eight patients with Nelson's syndrome were treated with a pituitary implant of yttrium-90 or gold-198 four to 16 years after adrenal surgery. All had considerable pigmentation. One already had cranial nerve abnormalities and visual field defects and had had both a craniotomy and deep x-ray treatment. Radiographs showed that the pituitary fossa was abnormal in seven patients. A biopsy performed in six cases showed mucoid (or basophil) adenoma in all. In the four specimens examined ACTH was identified by electron microscopy or immunofluorescence, or both. Patients were followed up after pituitary implantation for three months to 12 years. All showed decreased pigmentation, and six became normal. Four patients regained normal ACTH levels and the other two studied had decreased levels. In no case did new cranial nerve disease or further sellar expansion develop since operation, and two patients showed remodelling of the sella. Complications were temporary leakage of cerebrospinal fluid and diabetes insipidus in one patient and gonadotrophin deficiency in another.

Citing Articles

Corticotroph tumor progression after bilateral adrenalectomy (Nelson's syndrome): systematic review and expert consensus recommendations.

Reincke M, Albani A, Assie G, Bancos I, Brue T, Buchfelder M Eur J Endocrinol. 2021; 184(3):P1-P16.

PMID: 33444221 PMC: 8060870. DOI: 10.1530/EJE-20-1088.

The pituitary before and after adrenalectomy for Cushing's syndrome.

Manolas K, Farmer H, Wilson H, Kennedy A, JOPLIN G, Montgomery D World J Surg. 1984; 8(3):374-87.

PMID: 6087575 DOI: 10.1007/BF01655082.

Trans-sphenoidal microsurgical treatment of Nelson's syndrome.

Fukushima T Neurosurg Rev. 1985; 8(3-4):185-94.

PMID: 2993956 DOI: 10.1007/BF01815443.

ACTH secreting pituitary tumours.

Nabarro J J R Coll Physicians Lond. 1977; 11(4):363-75.

PMID: 196076 PMC: 5368756.

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