Diagnosis and treatment of pituitary tumours: a starting-point for manipulation of cancer with hypothalamic hormones

In order to make a well-founded choice between the therapeutic modalities presently available it is important to have a clear picture of the differences in the natural history of the various types of pituitary tumours. One of the most important questions regards possible differences in the tendency of the various tumours to grow extrasellarly. A related question concerns the relationship between the secretion rate of growth hormone, prolactin etc. and the size of the respective tumour. In other words: do high serum levels of these hormones in general indicate the presence of a large tumour and do moderately increased levels point to a smaller tumour? A parallel and for the management sometimes crucial question is a possible relationship between tumour growth rate and the age of the patient. Furthermore, one can ask what - in a therapeutic sense - may be the significance of a combined secretion of growth hormone and prolactin by a pituitary tumour. The therapeutic part of our study concerns the efficacy and the rapidity, with which the desired therapeutic endpoint may be reached by means of (transsphenoidal) surgery, irradiation or the combination of these treatments in the various types of pituitary tumours. Furthermore, we have considered the value of medical treatment as an additional or - possibly - as primary therapy.