S-C-3. Tumors in the Pituitary Region
Takeo KuwABARA Departmentof Neurosurgery,University of Tokyo
Out of 2,393 cases of intracranial tumors hospitalized and treated in the Dept. of Neurosurgery, Tokyo University Hospital, till the end of July, 1965, 479 tumors or 200/ of the total turned out to be tumors found in the pituitary-chiasmal region. These 479 cases of pituitary-chiasmal region tumors were classified as follows : Pituitary adenoma 269 Chromophobe adenoma 208 Eosinophilic adenoma 32 Mixed adenoma 11 Maligent adenoma 18 Pituicytoma 3 Craniopharyngioma 145 Meningioma of the tuberculum sellae 33 Glioma of the optic chiasm or nerve 15 Sellar chordoma 5 Epidermoid 4 Ependymoma I Teratoma and teratoid 2 Ectopic pinealoma 2 (1) The authors discussed on symptomatology and X-ray findings of the tumors belonging to four main groups, namely, adenoma, cranio- phryngioma, meningioma and glioma, from the clinico-statistical view-point. (2) In pituitary adenomas, operative mortality was 4.1 %o and a 5-year survival rate was seen in 72% of cases. And it was proved that post- operative radiotherapy have remarkably reduced the recurrence rate. Sta- tistics showed that in the group with post-operative radiotherapy, recurrence have occurred in only 9%0, whereas in the group without radiotherapy, recurrence was observed in 31.2o o/. (3) In craniopharyngioma, operative mortality was brought down from 12% to 9go, within a peiod of 5 years. The procedure of evacuation of the cyst and a partial removal of the capsule was found to be inadequate with a poor follow-up result. A 5-year survial rate was only 270%. These facts will necessitate to adopt more radical procedures such as tatal removal of the tumor or radiotherapy following operation. -92- (4) A brief history of the sella chordoma and sella epidemoid was presented and some characteristic features of these tumors were pointed out
S-C-4. The Surgical Removal of Pinealoma and Pineal Teratoma
Jiro SUZUKI Divisionof Neurosurgery,Institute of Brain Diseases, TohokuUniversity School of Medicine
The incidence of pinealoma among glioma in Japan was nearly 9 times higher than that in America or Europe. Such high incidence may be due to the difference of races. I have already experienced 25 cases of pinealoma, of which 3 cases were teratoma, 3 cases double tumor, 1 case astrocytoma, I case meningioma in the pineal region and 5 cases ectopic pinealoma, according to the histo- logical confirmation. The surgical removal of a pinealoma continues to be one of the most challenging problems for neurosurgeons and the most popular treatment of this tumor has been shunt operation and/or radiotherapy. Inspire of the great surgical risk there is a possibility of total removal of a pinealoma with a permanent cure. In 19 cases, pinealoma, double tumor and teratoma in pineal region have been recently removed surgically by myself with the aid of meticulous operative techniques, of continuous ventricular drainage, of hypothermic anesthesia, of admistration of corti- costeroids and anticonvulsants, of parenteral fluid therapy and other careful postoperative treatments. Out of these 19 cases, 4 died before discharge, 15 being bischarged in good or fairly good condition. Out of these 15 cases, 4 died after discharge from the hospital, and though one case is still un- known to me, 10 cases are living a healthy life, one case of which has been working as a carpenter for 7 years.
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