Treatment of Prolactin-Secreting Pituitary Tumours in Young Women by Needle Implantation of Radioactive Yttrium

Twentyone young female patients are described who presentedwith amenorrhoea, galactorrhoea or infertility, and were treatedby ⁹⁰Y pituitary implantation of 20 000 rads. There was no morbidity.In all patients serum prolactin values were elevated and radiographsof the pituitary fossa were abnormal. Observations are available for 1–76 months (mean 27) afterimplantation. The median fall in prolactin values was 60 percent while there was no deterioration in pituitary functionif normal pre-operatively. Luteinizing hormone values, bothbasally and following gonadotrophin-releasing hormone, roseto normal after operation; several instances of sellar remodellingwere observed radiologically, and no instance of relapse wasfound radiologically, biochemically or clinically. Thirteen patients desiring fertility have been observed sinceimplantation; so far nine have become pregnant, in three instanceswithout any additional therapy; since four patients became pregnanttwice, a total of 13 pregnancies have occurred. No case of tumourexpansion was observed during pregnancy. ⁹⁰Y implantation can be considered as a therapeutic procedurein young female patients requiring fertility which is competitivewith surgical methods, and together with a short course of bromocriptineif needed, could prove to be the treatment of choice.