[Recurrence of Cushing's disease in a child after transsphenoidal excision of a pituitary adenoma: hypothalamic change?].
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.
Barcia Vidal
E
E
Servicio de Pediatría, Centro Especial Ramón y Cajal, Madrid.
Barrio Castellanos
R
R
Lucio Murillo
A
A
Alonso Blanco
M
M
Yturriaga Matarranz
R
R
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
D006854:Hydrocortisone
Recidiva de la enfermedad de Cushing en un niño adenomectomizado por vía transesfenoidal: alteración hipotalámica?