Hypophysectomy is the surgical removal of the hypophysis (pituitary gland). It is most commonly performed to treat tumors, especially craniopharyngioma tumors. Sometimes it is used to treat Cushing's syndrome due to pituitary adenoma. It is also applied in neurosciences (in experiments with lab animals) to understand the functioning of hypophysis.
Medications that are given as hormone replacement therapy following a complete hypophysectomy (removal of the pituitary gland) are often glucocorticoids. Secondary Addison's and hyperlipidemia can occur. Thyroid hormone is useful in controlling cholesterol metabolism that has been affected by pituitary deletion.
Hypophysectomy performed at any age causes atrophy of the thyroid and adrenal glands as well as asthenia and cachexia. When the procedure is performed before sexual maturity, the reproductive tract remains undeveloped and non-functional. There is also a general lack of growth. If performed after sexual maturity, there will be a loss of reproductive function along with atrophy of gonads and accessory reproductive structures.
There is a risk of cerebral spinal fluid leak due to penetration of the basal skull, risk of increased cerebral spinal fluid pressure that may lead to central nervous system changes. Post surgery, patients may have a severely altered self-image that may lead to an increased risk of suicide. There is also an increased risk of hemorrhage and infection secondary to the surgical procedure.
- Jaffe, CA (2006). "Clinically non-functioning pituitary adenoma". Pituitary. 9 (4): 317–21. doi:10.1007/s11102-006-0412-9. PMID 17082898.
- Buchfelder, M; Schlaffer, S (2010). "Pituitary surgery for Cushing's disease" (PDF). Neuroendocrinology. 92 Suppl 1: 102–6. doi:10.1159/000314223. PMID 20829628.
- "Dramatically Increased Intestinal Absorption of Cholesterol Following Hypophysectomy Is Normalized by Thyroid Hormone" (PDF).
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