Efficacy of cryohypophysectomy in the treatment of acromegaly. Evaluation of 54 cases.

Between 1963 and 1974, 54 patients with acromegaly (28 men and 26 women) ranging in age from 23 to 61 years were evaluated. Each patient underwent thorough preperative neurological, roentgenographic, and endocrinological surveys; most demonstrated mild-to-severe abnormalities in growth hormone immunoassay and oral glucose tolerance. Of those who underwent stereotaxic cryohypophysectomy, approximately 80% were considered to have a beneficial result. The efficacy of this form of therapy was judged on the basis of: 1) significant overall clinical improvement and regression of acromegalic features; 2) improvement in the glucose tolerance curve; and 3) a fall of serum growth hormone below 10 ng/ml. Complications including rhinorrhea, meningitis, and hemorrhage occurred in only a small number of cases. A comparison is made between this technique and other, including craniotomy, radiotherapy, and transnasal transsphenoidal hypophysectomy. The efficacy, low morbidity, and the ease with which the procedure may be performed make this our treatment of choice when dealing with growth-hormone-producing pituitary adenomas with no suprasellar extension.