794 



J. P. SIMOKDS 



TABLE II 



types of enlargements and tumors of the hypophysis. The great majority 

 of cases of acromegaly were associated with strumas or adenomas that 

 were rich in eosinophil cells. 



Malignancy in tumors of the hypophysis manifests itself chiefly by 

 the manner and extent of its invasion of the capsule and adjacent tissues. 

 They sometimes erode and grow into the sphenoid bone, and even invade 

 the roof of the pharynx or the orbit. They may spread out over the 

 surface of the dura mater, or invade the substance of the brain itself. 

 Metastases are exceedingly rare. When they do< occur, they are usually 

 within the cranial cavity. Thus Smoler and Stolpe encountered metastases 

 in the brain, and Cagnetto(a), in the meninges of the spinal cord in cases 

 of malignant tumors of the hypophysis, I have found in the literature no 

 references to metastases in distant organs. The anterior lobe of the 

 hypophysis is richly vascular, and the tumors which originate from it 

 also contain numerous thin-walled blood vessels. As pointed out by 

 LeCount it is difficult to explain the absence of metastases in sarcomas of 

 an organ that is so copiously supplied with blood vessels. This very 

 absence of metastases casts doubt upon the accuracy of the diagnosis of 

 sarcoma of the hypophysis, 



Hyperplasias. In certain pathological and physiological states affect- 

 ing other organs of the body, the hypophysis usually undergoes hyperplasia 

 or hypertrophy. The increase in size is distinct but moderate and uni- 

 form ; and the weight rarely exceeds 1.5 grams. The enlargement takes 

 place in the transverse and vertical diameters, so the first evidence of 

 enlargement of the hypophysis is manifested by a bulging of the dura 

 mater covering the sell a turcica. The sella turcica itself is not enlarged 

 and the bones forming it do not undergo pressure atrophy. 



