The pituitary body and its disorders : clinical states produced by disorders of the hypophysis cerebri. An amplification of the Harvey Lecture for 1910.

  • Cushing, Harvey, 1869-1939.
Date:
1912
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Licence: In copyright

Credit: The pituitary body and its disorders : clinical states produced by disorders of the hypophysis cerebri. An amplification of the Harvey Lecture for 1910. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

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    the foramina for the nerves, where some of them are as large as the tip of the finger. There is a marked foraminal {F. magnum) herniation, accounting for the terminal medullary symptoms. The dura shows an extraordinary warty appearance, due to the protrusion of the many arachnoidal hornicp of Wolbach men- tioned above. On dissecting away the much flat- tened si)henoidal cells the protrusion of practically a normal sized sella is seen. Its floor consists of a thin scale of bone containing some pressure perforations. There is an enormous solid tumor mass occupying the interpeduncular region, widely dislocating all anatomical landmarks of the neighborhood. The tumor has invaded the upper part of the ethmoid, which has been partly broken away during removal (Fig. 77). This portion consists of a solid bony growth in which the optic nerves have evidently been compactly embedded (accounting for the fact that no choked disc was superimposed on the primary atrophy). A mid-longitudinal section (Fig. 77) shows a large, sharply outlined growth about the size of a tennis ball. Its cut surface is dry, granular and of a pinkish color. Though generally spher- ical in shape, there are certain prolon- gations, one in particular which fills the Fig. 80.—Case VIII. Section of tumor (endothelioma: (Mag. 190 diams.) Fig. 81.—Case VIII. Showing flattened hypophy.sis with superimpo.sed tumor, cleft and wide-meshed pars nervosa. (Mag. 10 diams.) Note colloidal cyst in thinned sella and which has flattened the hypophysis to a saucershaped structure, 1.5 mm. in thickness. The infundibular stalk passes down behind the tumor (cf. Case XVII, Fig. 126, in which the tumor has pushed the stalk forward) to the posterior edge of the gland (Fig. 78). It has been drawn out to a length of 3 cm.