Pluridirectional tomography in the evaluation of pituitary tumors

A series of 110 patients with suspected pituitary tumors was recently evaluated by endocrinologic and neuroradiologic studies. Of the 77 patients in this series who underwent surgery, 74 had confirmed pituitary adenomas, two had suprasella tumors of the influndibulum, and one had an empty sella not previously diagnosed at pneumoencephalography. All 17 patients with normal plain skull films but abnormal thin section tomography who underwent surgery had documented pituitary tumors. This includes six patients who presented with amenorrhea and/or galactorrhea and normal baseline serum prolactin levels; the only abnormality was found on tomography of the sella. In the preoperative evaluation of these patients, pluridirectional tomography of the sella was the most sensitive indicator of intrasellar pathology.