RESUMEN
A 40-year-old woman had visual loss and a large nonfunctioning pituitary tumor. After partial surgical resection and radiation treatment, clinical and biochemical evidence of Cushing's disease developed. The pituitary source of her adrenocorticotropic hormone hypersecretion was documented on selective venous sampling. After 18 months of medical therapy with metyrapone and aminoglutethimide, the patient experienced a spontaneous remission of her hypercortisolism. A "nonfunctioning" pituitary tumor has a hypersecretory potential.
Asunto(s)
Adenoma Cromófobo/complicaciones , Hormona Adrenocorticotrópica/metabolismo , Síndrome de Cushing/etiología , Neoplasias Hipofisarias/complicaciones , Adenoma Cromófobo/metabolismo , Adenoma Cromófobo/cirugía , Adulto , Aminoglutetimida/uso terapéutico , Síndrome de Cushing/tratamiento farmacológico , Femenino , Humanos , Metirapona/uso terapéutico , Pruebas de Función Hipofisaria , Neoplasias Hipofisarias/metabolismo , Neoplasias Hipofisarias/cirugíaRESUMEN
Theorists at the interface of medicine and the humanities have recently suggested that interpretation as a literary activity can be applied to the practice of clinical medicine. This article reviews such theories and their literary metaphors and methods. In pushing these ideas further, it is proposed that a number of guidelines can be applied to interpretation as a practical activity for clinical medicine.