ROENTGEN THERAPY IN CUSHING'S SYNDROME WITHOUT ADRENOCORTICAL TUMOR*

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Abstract
INTRODUCTION THE purpose of this article is, first to present the results of pituitary irradiation in 12 cases of Cushing's syndrome without detected adrenocortical tumor, and second to analyze the possible reasons for variation in effectiveness of roentgen therapy in these and adequately documented cases noted during a partial review of the literature. Our results, in conjunction with those of others, suggest that the effectiveness of a given total dose of x-ray to the pituitary is greater if the length of the course in days is relatively short. METHODS AND MATERIALS The records of the Medical Service, the Endocrine Clinic, Section of Medicine, and the Department of Radiology of the Hospital of the University of Pennsylvania, and the private records of two of us were reviewed for the period 1932–1952. Only those patients were included in this study who fulfilled the diagnostic requirements of Cushing's syndrome without demonstrable adrenocortical tumor, and who were treated by roentgen therapy of the pituitary region. Factors in the diagnosis of Cushing's syndrome are indicated in the case histories (Appendix), as are the methods used in the attempt to eliminate the possibility of adrenocortical tumors. The inclusion of Case #5 (M.H.) requires comment. The left adrenal gland had been removed from this patient nine weeks prior to instituting roentgen therapy. There was no evidence of improvement until the usual time after completion of roentgen therapy. We have included this patient, in view of this and other considerations discussed in the case history (see Appendix).