Stereotactic Cryohypophysectomy

History of cryosurgery

“…After his development of cryosurgical apparatus, interest in clinical cryosurgery burgeoned. Rand et al described a technique for stereotactic cryohypophysectomy via a transsphenoidal approach in patients with metastatic breast cancer and noted that total destruction of the pituitary gland and relief of symptoms could be achieved [47]. Wilson and associates reported on stereotactic cryohypophysectomy for functioning pituitary tumors, carcinoma of the breast, and carcinoma of the prostate [48].…”

Stereotactic treatment of acromegaly.

“…In all cases, yttrium90 sources or the cryogenic probe were introduced via the transnasal route using the Rand-Wells stereotactic apparatus, as previously described (Rand, Dashe, Paglia, Conway, and Solomon, 1964).…”

“…One or two centrally placed cryogenic lesions were used. The success of such lesions has been previously published, along with the development and rationale for this technique (Rand et al, 1964). Lateral to the sella contents is the rapidly flowing blood contained in the cavernous sinus and carotid arteries.…”

“…Visual fields, visual acuity, and extraocular mo'yements were tested continuously during the active freezing of the probe tip, as previously described (Rand et al, 1964). Yttrium90 implantations were performed under general anaesthesia.…”

Surgical Pathology of Cryohypophysectomy

“…R and, Daslie, Paglia, Conway and Solomon (1964) pub lish ed a series of stu d ies on ste re o ta x ic tran ssp h en o id al cryoh y p o p h y secto m y in p a tie n ts w ith w idespread m a m m a ry carcinom a, severe progressive d iab etic re tin o p a th y a n d p itu ita ry h y p erp lasia or ad en o m ata. E x perience w ith this tech n iq u e in a p p ro x im a te ly 60 cases in d icates th a t it has overcom e m a n y o f th e d isa d v a n ta g e s and clinical com plications of o th e r h y p o p h y seal a b la tiv e procedures.…”