The extra-sellar post-hypophysectomy remnant

Abstract

IT is generally accepted that the aim of hypophysectomy in the treatment of advanced mammary cancer is the total destruction of tissue producing adenohypophysial hormones. Various techniques of hypophysectomy are described in the literature. In each technique particular emphasis is laid on the completeness of the destruction of the sellar hypophysis. Reference in the literature to extra-sellar hypophysial tissue is infrequent. The pharyngeal hypophysis, however, has been shown histologically to contain active adenohypophysial tissue (Melchionna and Moore, 1938;Willis, 1958; Miiller, 1958; McGrath, 1967) and fractionation of pharyngeal hypophyses has yielded significant amounts of prolactin and human growth hormone (McGrath, 1968). The aims of this presentation are to describe a large pharyngeal hypophysis as a feature of the nasopharynx and to discuss the probable fate of the pharyngeal hypophysis in the various techniques of trans-sphenoidal hypophysectomy. MATERIALS AND METHODSThe pharyngeal hypophysis described in this paper was removed from the embalmed cadaver of R. D., a female of 88 years. The subject was a self-donor. The cause of death was recorded as bronchopneumonia and congestive cardiac failure. Embalming was commenced 15 hours after death, and the tissue was removed from the cadaver 13 months later.The mucoperiosteum containing the pharyngeal hypophysis was removed via the nasal cavity. The segment was embedded in paraffin and sagittal sections were cut at 7p intervals. Approximately thirty sections were mounted on each 4 in. x 2 in. slide. Every second slide was stained with haematoxylin and eosin. The pharyngeal hypophysis was located and examined histologically. Additional slides were then stained with PAS-orange G.The maximum sagittal dimension of the pharyngeal hypophysis was measured macroscopically using sections shown in Figs. 4 and 5. The maximum transverse dimensions of the anterior and posterior portions of the pharyngeal hypophysis were estimated from the number of sections in which the respective portions appeared. The maximum vertical dimension of the pharyngeal hypophysis was determined with an ocular micrometer. The volume of the pharyngeal hypophysis was measured by a technique previously reported (McGrath, 1967).A model of the pharyngeal hypophysis of R.D.was constructed of cardboard. In the construction of the model each consecutive sagittal section was projected at x71 on to cardboard 0.5 mm. thick. Cut-outs representing the sections of pharyngeal hypophysis were glued together and the cardboard model was then coated in Silastic (Figs. 8, 9). FINDINGSThe segment of mucoperiosteum removed from R. D. consisted of a narrow, concave vomerine section and a wider, flat sphenoidal section. The most prominent feature was the vascular nubble projecting superiorly from the deep surface of the sphenoidal section (Figs. 2, 3). Severed fibrous strands and vessels projecting anteriorly were evident on the deep surface a t the junction of the vomerine and sphenoidal sections. In situ, the va...

Human pharyngeal and sellar pituitary glands: differences and similarities revealed by an immunocytochemical study

“…It is reasonable to suppose that the pharyngeal pituitary will respond with specific changes if a hormonal imbalance has not been adequately compensated for by the sellar adeno¬ hypophysis. This has probably been the origin of the conflicting opinions on the functional capacity of the pharyngeal pituitary (Melchionna & Moore, 1938;Müller, 1958;Van Büren & Bergenstal, 1960;Hachmeister, 1967;McGrath, 1969;McPhie & Beck, 1973;McGrath, 1978). In the present study, (Gluckman, Grumbach & Kaplan, 1981) In the mucoperiosteum situated at the conjunction of the sphenoid and vomer bones.…”

“…These data demonstrate that the pharyngeal hypophysis has the capacity to produce adenohypophyseal hormones, and support the concept that the gland is able to undergo specific modifications following changes in endocrine feedback. However, the possibility that the pharyngeal hypophysis might play a significant functional role in the physiopathology of the hypothalamo-adenohypophyseal system is still controversial (Melchionna & Moore, 1938;Müller, 1958;Van Buren & Bergenstal, 1960;Hachmeister, 1967;McGrath, 1969;McPhie& Beck, 1973;McGrath, 1978).…”