title: Cyclic Cushing's disease associated with primary empty sella.
abstract: A small number of cases of Cushing's disease (CD) associated with primary empty sella (ES) have been described in the literature. Pituitary microsurgery is the recommended treatment. An alternative is chronic treatment with ketoconazole, an inhibitor of adrenal cortisol synthesis. Cyclic Cushing's syndrome is characterized by episodic cortisol hypersecretion. CD is the most frequent etiology of cyclic Cushing's syndrome. To our knowledge, cyclic CD has not previously been reported in association with primary ES. We describe a patient with cyclic CD associated with primary ES who was initially treated with ketoconazole and subsequently cured by transsphenoidal surgery.
authors.affiliation: Internal Medicine Service, Infanta Cristina Universitary Hospital, Badajoz, Spain
authors.initials: JM
authors.lastname: Calvo-Romero
authors.initials: F
authors.lastname: Morales-Pérez
authors.initials: J
authors.lastname: Díaz-Pérez