Cushing's disease resulting from pituitary corticotrophic microadenoma. Treatment results from transsphenoidal microsurgery and gamma knife radiosurgery.
Cushing's disease and its associated clinical syndrome reflect the effects of excess cortisol on the individual. The cause of Cushing's disease is ordinarily an ACTH-secreting benign pituitary adenoma. The diagnosis of Cushing's disease is established by sophisticated endocrine testing and comprehensive imaging studies. Because of the devastating effects of excess cortisol, therapy that provides prompt and effective normalization of serum cortisol is essential. Currently this goal is best achieved by transsphenoidal microsurgery. This paper reviews the clinical presentation, laboratory analysis, surgical management and outcome in patients with Cushing's disease.
Laws
E R
ER
Department of Neurosurgery, University of Virginia, Charlottesville, VA 22908-0212, USA. EL5G@virginia.edu
Reitmeyer
M
M
Thapar
K
K
Vance
M L
ML
D000236:Adenoma / Q000209:etiology / Q000378:metabolism / Q000601:surgery*; D003480:Cushing Syndrome / Q000209:etiology / Q000601:surgery*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism; D007016:Hypophysectomy / Q000379:methods; D007018:Hypopituitarism / Q000209:etiology; D008279:Magnetic Resonance Imaging; D008297:Male; D010641:Phenotype; D010911:Pituitary Neoplasms / Q000209:etiology / Q000378:metabolism / Q000601:surgery*; D010913:Pituitary-Adrenal System / Q000503:physiopathology; D011183:Postoperative Complications; D016634:Radiosurgery / Q000009:adverse effects; D012074:Remission Induction; D016879:Salvage Therapy; D016896:Treatment Outcome
D006854:Hydrocortisone