papillary carcinoma and lymph node metastases. She was reoperated in 1972 because two radioactive sites were seen in the neck on I scanning, but no recurrent disease was found at surgery. During examination at Tripler Army Medical Center in April 1976, a routine skull x-ray showed erosion of the anterior floor of the sella turcica and a mass extending into the sphenoid Sinus. There were no related symptoms and no visual field loss, and menses were normal. Thyroid hormone treatment had been discontinued for radioiodine testing, and the serum thyroid stimulating hormone (TSH) was elevated (Table 3A). Serum follicle-stimulating hormone (FSH) and luteinizing hormone (LH) were high and growth hormone (GH) was normal. Table 3. A. Endocrine function tests on pituitary tumor case: (normal values in parentheses). April 1976 Serum TSH 9.8 w/ml FSH 116 mIU/ml (20-30) Ty 0.3 ug/d1 (5-10) LH GH T3 B. May Serum 1976 FSH (<5) mIU/ml (<20) ng/ml (0.2-5) 16 ng/dl (60-160) 31.2 27.8 18.2 17.6 mIU/ml mIU/ml mIU/ml mIU/ml (follicular 9-27, midcycle 7-41) (luteal 5-15, postmenopausal 35-217) (follicular 6-27, midcycle 45-154) (luteal 5-17, postmenopausal 39-96) AM cortisol 8.0 44 58 10 ng/ml pg/ml pg/ml pe/dl (follicular 10-100, mideycle 170-770) (luteal 190-340, postmenopausal <10-140) (6-26) Ty, 9.4 g/dl (4.6-10.7) lt pe/dl T3 2.7 149 ng/dl (110-230) ng/dl LH PRL estradiol FT, Urine 59 4 hormone levels 17-OH corticoids 17-ketosteroids 9.1 ng/ml (16.2 + <2) (1.0-2.3) 1.6, 2.2, 1.2, 1.5 mg/24 hr (2.0-6.0) 4.0, 5.0, 2.0, 4.0 mg/24 hr (9.0-22.0) She was admitted to the Clinical Center of the National Institutes of Health on 18 May 1976 for further study. Laboratory tests showed normal electrolytes, and the results of endocrine function tests (Table 3B) were within normal limits except for a slight decrease in the 24-hr urinary 17- hydroxycorticoids and 17-ketosteroids. Skull x rays and sella tomograms revealed an asymmetric erosion in the anterior floor of the sella with exten- sion of a soft tissue mass into the sphenoid sinus. showed no supracellular extension. Computerized tomography Visual fields were normal. ~ 50 -