title: [Recurrence of Cushing's disease in a child after transsphenoidal excision of a pituitary adenoma: hypothalamic change?].
abstract: A case of Cushing disease in a 5 4/12 year-old boy is reported. After adenomectomy was performed, he was considered as "cured" but he relapsed after nineteen months. In a second transsphenoidal surgery a 2 X 3 mm piece of pituitary tissue with adenomatous aspect, was removed. It was histologically constituted by normal pituitary cells and Crooke cells. As the patient was in a cortisol-deficient state a remission was established. Nowadays, since the cortisol response to hypoglycemia was positive, we are paying attention to the risk of relapse. We discuss the possibility of a hypothalamic lesion as the cause and different therapeutic strategies in order to be more selective.
authors.affiliation: Servicio de Pediatría, Centro Especial Ramón y Cajal, Madrid.
authors.forename: E
authors.initials: E
authors.lastname: Barcia Vidal
authors.forename: R
authors.initials: R
authors.lastname: Barrio Castellanos
authors.forename: A
authors.initials: A
authors.lastname: Lucio Murillo
authors.forename: M
authors.initials: M
authors.lastname: Alonso Blanco
authors.forename: R
authors.initials: R
authors.lastname: Yturriaga Matarranz
mesh_terms: D000236:Adenoma / Q000150:complications* / Q000503:physiopathology / Q000601:surgery; D002675:Child, Preschool; D003480:Cushing Syndrome / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D006854:Hydrocortisone / Q000502:physiology; D007031:Hypothalamus / Q000503:physiopathology*; D008297:Male; D010903:Pituitary Gland, Anterior; D010911:Pituitary Neoplasms / Q000150:complications* / Q000503:physiopathology / Q000601:surgery
chemical_list: D006854:Hydrocortisone
vernacular_title: Recidiva de la enfermedad de Cushing en un niño adenomectomizado por vía transesfenoidal: alteración hipotalámica?