Cushing’s disease - assessing the efficacy of transsphenoidal surgery

Cushing’s disease (CD) is caused by a pituitary adenoma secreting corticotrophin (ACTH) that leads to cortisol excess. Despite a characteristicclinical picture, it is often difficult to make a proper diagnosis, as it requires complex and long-lasting diagnostic procedures. Selective transsphenoidals...

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Bibliographic Details
Published in:Endokrynologia polska 2012, Vol.63 (5), p.398-404
Main Authors: Witek, Przemysław, Zieliński, Grzegorz, Maksymowicz, Maria, Kamiński, Grzegorz
Format: Article
Language:English
Subjects:
Steroids
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Summary:Cushing’s disease (CD) is caused by a pituitary adenoma secreting corticotrophin (ACTH) that leads to cortisol excess. Despite a characteristicclinical picture, it is often difficult to make a proper diagnosis, as it requires complex and long-lasting diagnostic procedures. Selective transsphenoidalsurgery (TSS) remains the treatment of choice for CD. Untreated or improperly treated Cushing’s disease leads to the developmentof serious complications, which lower patients’ quality of life. Mortality in this group is high, reaching 50% within a 5-year follow-up period.In this study, we present our own experience and discuss the importance of preoperative hormone measurements, magnetic resonanceimaging (MRI) of the pituitary, results of histopathological examination (immunohistochemical and ultrastructural in electron microscopy) and postoperativeearly and late hormonal assessment in the aspect of TSS efficacy. The performed analysis is based on the current criteria forremission of Cushing’s disease. Our study emphasises the need for long-term postoperative endocrinological follow-up, which facilitatesearly detection of recurrent hypercortisolemia. (Endokrynol Pol 2012; 63 (5): 398-403)
ISSN:0423-104X