Implantation of Yttrium90 in an Acromegalic Patient

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IMPLANTATION of radioactive substances in the pituitary gland has been used in an attempt to obtain more successful hypophysectomy than can be achieved with conventional X-ray treatment or cobalt60 teletherapy. The morbidity and mortality associated with other surgical methods are avoided.1–8 Heavy-particle irradiation has given promising results but is available in only a few medical centers.9 Yttrium90 (Y90) has been used, at the Cleveland Clinic, for pituitary ablation in metastatic breast cancer, in selected cases of diabetic retinopathy, in a few patients with Cushing’s syndrome, and in 20 patients with acromegaly to be reported with additional cases more extensively later. This report concerns a patient with acromegaly who underwent this form of treatment and in whom growth-hormone assays were made before and after the operation. It is hoped that growth-hormone assays will help in the evaluation of therapeutic results.

Methods of Study

Transnasal implantation of two sources of yttrium90 (5 mc. and 5.12 mc.) was performed according to the method of Forrest, Blair, and Valentine.1 In this method plastic capsules containing the radioactive material are held in stainless steel screws, which are screwed into burr holes in the floor of the sella turcica after insertion through the nostrils and the sphenoid sinus.

Blood glucose was determined by means of the AutoAnalyzer ferricyanide method.10 The glucose tolerance tests were done with 100 gm. of glucose orally, and venous blood sugar was measured at one and at two hours.

The growth-hormone assays were performed by Dr. Olof H. Pearson of the. . .



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