Vascular Lesions in Pituitary Adenomas

Abstract

HE textbook picture of a disease is developed by isolating schematically its salient features from a large variety of clinicopathologic observations and by attempting to reduce them to a common denominator. This endeavor of systematization certainly gratifies the urge of logical thinking, but by its arbitrary simplification tends to construct a fixed pattern which is only reluctantly discarded if new and perhaps contradictory facts are discovered. A good example of such a situation is found in our state of knowledge concerning hypophyseal adenoma. The well-known textbook concept of this type of neoplasm dates back to Cushing's classical description. With growing experience, however, confusing and therefore neglected variants of the disease had to be reconsidered. Jefferson, 5 for instance, gave an excellent analysis of unusual pituitary adenomas with extrasellar extension. In this article we propose to depict another aspect of the kaleidoscopic pituitary syndrome, viz., the vascular lesions occurring in pituitary adenoma. Knowledge of this condition is by no means new, and sporadic reports may be found even in the older literature. Brougham, Heusner, and Adams 1 deserve credit for having collected all these reports; and on the basis of 5 new observations have redirected our attention to the problem. Since their publication we were able to find 3 additional articles dealing with this subject. 4,6,7