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Hypophysectomy
Surgical and chemical (stereotactic transsphenoidal) hypophysectomy are similar procedures that each offer a 40 to 70 percent likelihood of pain relief.281 The mechanism by which pain relief is achieved is unknown, but it is not related directly to the expected fall in the pituitary hormone levels, because pain relief is achieved in hormonally independent and dependent tumors.251; 288; 456 The clearest clinical indication is for bilateral or diffuse bone pain from metastatic disease that has failed to respond to all other hormonal, radiation, or medical therapies. Hormone replacement therapy is needed to replace pituitary secretion. Potential complications include endocrine deficits, damage to the optic nerves or oculomotor apparatus from the injected chemical agent, and cerebrospinal fluid (CSF) leakage.98; 270; 288
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