The warp factor

Diagnosis and Management of Pituitary Tumorsedited by Kamar Thapar, Kalman KovacsBernd W. Scheithauer and Ricardo V. LloydHumana Press, 2002. US$225.00(xiv + 479 pages) ISBN 0 896 03403 8View Large Image | Download PowerPoint SlideThe greatest gifts brought to Earth by the intrepid crew of the Starship Enterprise were the freedom to use the split infinitive (‘…to boldy go…’) and the ‘warp’. The ‘warp’, as any Trekkie knows, is a contraption (or just some kind of principle) that allows one to move faster than the speed of light and, therefore, travel through time. As a result, objects and personalities from different eras could either blend seamlessly or, alternatively, clash jarringly, producing a surrealistic mosaic of contradictions and inconsistencies. Unfortunately, this alternative outcome is the feeling that one gets whilst reading Diagnosis and Management of Pituitary Tumors.This book is the newest addition to the expanding library of clinical and experimental neuroendocrinology. It is supposed to compete with two larger textbooks: The Pituitary (Blackwell Science, 1995) and Pituitary Adenomas (Churchill Livingstone, 1996). The five-year gap since the publication of these books should have allowed the authors and the editors to capitalize on the rapid expansion of the field and to provide a uniformly novel and contemporary overview of experimental and clinical neuroendocrinology. Unfortunately, this goal has not been achieved.It appears that this book was mostly written during 1994–1995 and then just gathered dust in the publisher's office. Several authors made an obviously heroic effort to update their contributions at the last moment, which is why chapters on ‘Acromegaly’ and ‘Medical therapy of pituitary tumors’ have so many ‘lettered’ references from 1997–2000. Much of the book, however, is quite outdated.For example, in the chapter on radiation therapy, of a total of 107 references, only two were published in 1995 (none more recently than that). New data on the efficacy of radiation therapy (XRT) in acromegaly using insluin-like growth factor-I to judge success, on the salutary effects of the combined ketoconazole/XRT approach to non-cured Cushing's disease, the prevention of non-functioning pituitary adenoma regrowth by radiation, and the rapid developments in stereotactic radiotherapy are all missing from the discussion. The chapter on prolactinomas contains the statement, ‘Cabergoline is currently available for compassionate use in the US.’ This is a strange statement in a book published in 2001, because this drug has been on the market in the US since 1996! This book is also disproportionately oriented toward pathology of pituitary and parapituitary lesions. A total of five chapters, ∼160 pages (almost one-third of the entire book) and >1300 references are dedicated to this subject, whereas the entire review of the physiology of the hypothalamic–pituitary area is covered in 15 pages and 29 citations.The chapter ‘Anatomy of the pituitary gland and sellar region’ by Albert L. Rhoton, Jr is particularly puzzling. As far as I can see, it has already been published (under a slightly different title, ‘Microsurgical anatomy of the pituitary region’) in Pituitary Adenomas (Churchill Livingstone, 1996). I spent close to an hour looking for differences between the two chapters and could not find any with the exception of how the citations were arranged. If the editors and the publishers were informed about this double publication, they should have at least included an appropriate disclaimer. If they were not…. Well, Captain Kirk also had a problem like this once. Because of a malfunctioning transporter he came back to the Enterprise accompanied by his evil twin.Beam me up Scottie.