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Harvey Cushing's attempt at the first human pituitary transplantation

Nature Reviews Endocrinology volume 6, pages 48–52 (2010)Cite this article

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Abstract

Background. This case study illustrates Harvey Cushing's pioneering work in pituitary transplantation in the early 20th century and the essential relationship between laboratory research and clinical practice. In 1911, a 48 year-old man presented at Johns Hopkins Hospital with bitemporal hemianopsia, hypothermia, hypersomnolence, decreased libido, polydypsia and polyuria.

Investigation. A review of the Johns Hopkins Hospital surgical records from 1896–1912 on a patient with hypopituitarism secondary to a suprasellar mass, in whom the first documented pituitary gland transplantation was performed.

Diagnosis. A diagnosis of hypopituitarism was made. Postmortem examination revealed a cystic cavity lined with squamous epithelium.

Management. The patient was treated with whole-gland pituitary extract, which improved his symptoms only temporarily. Cushing transplanted a pituitary gland obtained from a spontaneously aborted fetus into the cerebral cortex of the patient, who showed marked improvement of his somnolence and confusion, whereas his polyuria and polydypsia persisted. A recurrence of symptoms after 6 weeks prompted Cushing to attempt a second transplant of a fetal pituitary gland, without improvement. The patient resumed hormonal supplementation with whole-gland pituitary extract, but died a month after the second transplant from respiratory complications.

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Authors and Affiliations

  1. Department of Neurosurgery and Oncology, Johns Hopkins School of Medicine, 1550 Orleans Street, Cancer Research Building II, Room 253, Baltimore, 21231, MD, USA

    Courtney Pendleton, Hasan A. Zaidi, Gustavo Pradilla & Alfredo Quiñones-Hinojosa

  2. Clarian Neuroscience Institute, Indianapolis Neurosurgical Group, 1801 Senate Boulevard # 535, Indianapolis, 46202, IN, USA

    Aaron A. Cohen-Gadol

Authors
  1. Courtney Pendleton
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  2. Hasan A. Zaidi
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  5. Alfredo Quiñones-Hinojosa
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Correspondence to Alfredo Quiñones-Hinojosa.

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Pendleton, C., Zaidi, H., Pradilla, G. et al. Harvey Cushing's attempt at the first human pituitary transplantation. Nat Rev Endocrinol 6, 48–52 (2010). https://doi.org/10.1038/nrendo.2009.223

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