All issues > Volume 33(4); 1990

Original Article

J Korean Pediatr Soc. 1990;33(4):491-498. Published online April 30, 1990.

Pituitary Function on Patients with Sellar and Suprasellar Tumor.

Sei Won Yang¹, Hyung Ro Moon¹, Byung Kyu Cho²

¹Department of Pediatrics, College of Medicine, Seoul National University, Seoul, Korea
²Department of Neurosurgery, College of Medicine, Seoul National University, Seoul, Korea

Received: June 27, 1989;  Accepted: September 22, 1989.

Abstract

We observed the status of pituitary hormones (growth hormone, TSH, ACTH, gonadotropin and ADH) in the patients with intrasellar and suprasellar tumors (Table 1 and 2) before and after treatment of tumors. They were estimated from the results of various provocative tests to the pituitary hormones after confimation of normal thyroid function. The results were as belows (Table 3 and 4): 1) Most patients with craniopharyngioma and germinoma had GH dificiency before treatment of tumors. All patients with craniopharyngioma and most patients (75%) with germinoma had GH deficiency after treatment of tumors. 2) The incidence of TSH deficiency was less than that of TRH deficiency before and after treatment of tumors. It suggests that most lesions which make the pituitary hormones deficient exist in the hypothalamus. 3) The status of gonadotropin were evaluated only in patients whose bone ages were above 12 years old. Most patients with craniopharyngioma and germinoma had gonadotropin deficiency before and after treatment of tumors. This result suggests that most tumors which involve in the suprasellar area make the gonadotropin deficient. 4) Only two patients with craniopharyngioma showed partial deficiency of ACTH before treatment of tumors, but more than half patients showed ACTH deficiency after treatment of tumors, but 81% of the patients with ACTH deficiency showed partial responses to the insulin-induced hypoglycemia. 5) The symptoms and signs of diabetes insipidus were prominent in patients with craniopharyn- gioma and germinoma before and after treatment of tumors, but a few patients showed spontaneous regression of symptoms of diabetes insipidus within 14 months after treatment of tumors. In conclusion, all the patients with craniopharyngioma and germinoma must be considerd to have more than one pituitary hormone deficiency at least before and after treatment of tumors and should be evaluated by provocative tests of pituitary hormones routinely. The pathogenesis of hypopituitaism probably derives from the interruption of normal hypothalamic-pituitary relation by the tumors themselves, mainly in the hypothalamus but the methods of treatment including surgery and radiotherapy may participate in the occurrence of hypopituitarism.

Keywords :Hypopituitarism, Sellar, Suprasellar tumor