Selective hypophysectomy for metastatic pain. A review of ethyl alcohol ablation of the anterior pituitary in a Regional Pain Relief Unit.

Selective adenohypophysectomy, by the injection of up to 1 ml of absolute alcohol to the pituitary gland, was used to produce pain relief in 25 patients suffering from metastatic cancer. Thirty-five treatments were given and good analgesia was obtained in 74%. The median duration of pain relief was 6-7 weeks, although some treatments produced relief for up to 20 months. The procedure was most successful in relieving bone pain in patients with advanced carcinoma of the breast or prostate. The use of a fine-gauge needle for the intranasal trans-sphenoidal approach to the gland and the injection of alcohol to the anterior part (pars distalis) of the gland reduced the frequency of the major complications diabetes insipidus (17%) and prolonged visual disturbance (3%).