TREATMENT OF PROLACTIN-SECRETING PITUITARY TUMORS IN YOUNG-WOMEN BY NEEDLE IMPLANTATION OF RADIOACTIVE YTTRIUM

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  • 1 January 1978
    • journal article
    • research article
    • Vol. 47  (188) , 473-493
Abstract
Young female patients (21) are described who presented with amenorrhea, galactorrhea or infertility and were treated by 90Y pituitary implantation of 20,000 rads. There was no morbidity. In all patients serum prolactin values were elevated and radiographs of the pituitary fossa were abnormal. Observations were available for 1-76 mo. (mean 27) after implantation. The median fall in prolactin values was 60% while there was no deterioration in pituitary function if normal pre-operatively. Luteinizing hormone values, basally and following gonadotrophin-releasing hormone, rose to normal after operation; several instances of sellar remodeling were observed radiologically, and no instance of relapse was found radiologically, biochemically or clinically. Thirteen patients desiring fertility were observed since implantation; so far 9 have become pregnant, in 3 instances without any additional therapy; since 4 patients became pregnant twice, a total of 13 pregnancies occurred. No case of tumor expansion was observed during pregnancy. 90Y implantation can be considered as a therapeutic procedure in young female patients requiring fertility which is competitive with surgical methods, and together with a short course of bromocriptine if needed, could be the treatment of choice.