Partial pituitary ablation with implants of gold-198 and yttrium-90 for acromegaly.

The ideal -method for the treatment of acromegaly remains uncertain. Evidence of local pressure from a pituitary tumour offers an absolute indication for treatment, and this has usually been surgical decompression ; however, when treatment has been given by external deep x-ray therapy the majority of such patients have shown improvement in their visual-field defects (Fraser and Joplin, 1961). Where the presenting syndrome comprises only acromegaly and the other effects of excessive growth-hormone secretion the need for treatment may seem less obvious. The activity of acromegaly is difficult to assess, and the natural history of the untreated disease is not adequately known. Bishop and Briggs (1958) reported that 80% of their patients had died by the age of 60 predominantly from cardiovascular complications, but this high mortality rate awaits confirmation. Acromegaly without symptoms of a pituitary tumour has often been left untreated; however, we have implanted such cases as well as those with tumour signs