Pituitary, Pineal and Third Ventricle Tumours.

The pituitary gland is concerned with such diverse functions as growth, sexual activity, carbohydrate and water metabolism, physical energy and the character and distribution of hair. For its size it is a very eloquent structure and although not solely responsible for any of these activities, it has been described as the leader of the endocrine orchestra. Many of its disturbances of function are more in the province of the physician than the surgeon. This section is concerned only with the effects produced by tumours. For practical purposes only two types need description, the chromophobe and chromophil adenomas. These tumours acquire their descriptive titles from preponderance of either the chromophobe or chromophil cells found in the normal gland, although pure growths of either are rare, and in most cases it would be more correct to speak of a mixed-cell adenoma. The basophil element occasionally undergoes hyperplasia and in some cases is associated with what is widely known as Cushing's syndrome, but in about half the recorded cases of this condition the essential lesion seems to be in the suprarenal gland-another example of the inter-relation of the pituitary with other endocrine glands. The basophil adenoma is generally not a surgical problem, and although some good results have followed the implantation of radon seeds in the pituitary gland, treatment usually consists of deep X-rays directed to the region ofthe sella.