THE EFFECT OF SUPRASELLAR TUMOURS ON THE REGULATION OF ADRENOCORTICAL FUNCTION

Abstract

ABSTRACT The effect of distorsion of the hypothalamus on the hormone production by the adrenal cortex was studied in ten patients, nine of whom had tumours involving the suprasellar region. The spontaneous urinary excretion of 17-ketosteroids, 17-ketogenic steroids and Porter-Silber chromogens was normal in six out of the nine patients with suprasellar tumour, as well as in two without suprasellar involvement. The diurnal rhythm in 17-hydroxy-corticosteroids in plasma was absent in four out of seven patients with suprasellar tumour, and present in three such cases. Normal diurnal rhythm was also found in the patient without distortion of the hypothalamus. The capacity to increase steroid production on intravenous administration of ACTH was not impaired in any of the patients studied. The ability to increase ACTH secretion following depression of cortisol production by an 11β-hydroxylase inhibitor was present in five out of six patients with suprasellar tumour. The exception was a patient with clinical evidence of panhypopituitarism including low values for steroid hormones in blood and urine. Aldosterone was excreted by all patients, but six out of eight with suprasellar tumour failed to increase aldosterone excretion following salt restriction.