Pituitary surgery in Cushing's disease: first line treatment and role of reoperation
- PMID: 35857269
- DOI: 10.1007/s11102-022-01254-8
Pituitary surgery in Cushing's disease: first line treatment and role of reoperation
Abstract
Cushing's disease is the most common cause of endogenous hypercortisolemia, and transsphenoidal surgery remains the first line therapy for removal of the ACTH-secreting adenoma. While post-operative remission rates are high in experienced hands, there remains a 2% risk of recurrence per year. Patients with the highest chance for cure are those with small, non-invasive tumors that are visible on pre-operative MRI and identified during surgery and are performed by high-volume pituitary neurosurgeons. Surgery for persistent or recurrent disease is frequently indicated and is most successful in the hands of experienced surgeons and in cases where tumor is visible on MRI.
Keywords: Cushing’s disease; Cushing’s recurrence; Cushing’s remission; Transsphenoidal.
© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
References
-
- Nieman LK, Biller BMK, Findling JW et al (2015) Treatment of Cushing’s syndrome: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 100:2807–2831 - DOI
-
- Alexandraki KI, Kaltsas GA, Isidori AM et al (2013) Long-term remission and recurrence rates in Cushing’s disease: predictive factors in a single-centre study. Eur J Endocrinol 168:639–648 - DOI
-
- Valassi E, Biller BMK, Swearingen B et al (2010) Delayed remission after transsphenoidal surgery in patients with Cushing’s disease. J Clin Endocrinol Metab 95:601–610 - DOI
-
- Fleseriu M, Auchus R, Bancos I et al (2021) Consensus on diagnosis and management of Cushing’s disease: a guideline update. Lancet Diabetes Endocrinol 9:847–875 - DOI
-
- Goshtasbi K, Lehrich BM, Abouzari M et al (2020) Endoscopic versus nonendoscopic surgery for resection of pituitary adenomas: a national database study. J Neurosurg 134:816–824 - DOI
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