EFFECTS OF SURGICAL HYPOPHYSECTOMY IN A MAN WITH MALIGNANT MELANOMA*

Abstract

MALIGNANT melanoma in man displays a number of features which suggest that its development and growth may be related to or influenced by the endocrine system. Melanomas are almost never malignant before puberty, are not observed in castrated individuals, and their growth and dissemination are markedly accelerated during puberty and during pregnancy (1, 2). The clinical course of melanoma with metastases is uncompromising in its inexorable progress and cannot be modified by any presently known methods. Attempts to influence the neoplasm by castration, androgenic or estrogenic therapy have been unsuccessful. Pack and Scharnagel (3) performed bilateral adrenalectomy on two occasions without beneficial effects. Wigby and Metz (4) reported a patient with disseminated melanoma who had striking regression of subcutaneous and visceral metastases of melanoma following roentgen irradiation of the pituitary gland with approximately 4,500 r. No effects were observed, however, in 4 additional patients treated in this manner. Irradiation of the pituitary with up to 3,000 r has shown no effect on melanomas (3). We (5) have treated 1 such patient with a pituitary tissue dose of 8,500 r without modifying the course of the disease. Moreover, doses of irradiation up to 10,000 r to the normal adult pituitary gland have failed to produce any clinical, biochemical or histologic alterations in 3 patients.