[Cushing's disease and corticotroph adenoma: anterior pituitary function before and after trans-sphenoidal microsurgery].
OBJECTIVE
Cushing's disease is characterized by an overproduction of ACTH inducing an hypersecretion of corticosteroids. We assessed the non-corticotrophic pituitary functions before and after microsurgical resection of the corticotrophic adenoma.


METHODS
We reviewed retrospectively a series of 98 patients (19 males, 79 females) undergoing transsphenoidal surgery between 1974 and 2001. Prolactin levels, somatrotrophic, gonadotrophic and thyroidotrophic functions were assessed and compared before and after resection of the adenoma.


RESULTS
Before surgery, we observed an elevation of prolactin and a reduction of the GH, TSH, LH and FSH levels. These modifications were not linked to the volume of the adenoma but depended on the systemic effect of the hypercorticism or on local paracrine mechanisms. Selective adenomectomy usually restored altered corticotrophic and also, unlike (partial or total) hypophysectomy, the non-corticotrophic functions.


CONCLUSIONS
Non-corticotrophic functions are often altered in Cushing's disease but can be restored after selective adenomectomy.
Martin
D
D
Service de Neurochirurgie, Centre Hospitalier Universitaire, Domaine Universitaire, Belgique, France. didier.martin@chu.ulg.ac.be
Valdes-Socin
H
H
Beckers
A
A
Stevenaert
A
A
D000236:Adenoma / Q000150:complications / Q000378:metabolism / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003480:Cushing Syndrome / Q000209:etiology / Q000503:physiopathology* / Q000601:surgery; D005260:Female; D019382:Human Growth Hormone / Q000378:metabolism; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism; D007016:Hypophysectomy / Q000379:methods*; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000601:surgery; D010901:Pituitary Function Tests; D010903:Pituitary Gland, Anterior / Q000378:metabolism / Q000503:physiopathology*; D010908:Pituitary Hormones, Anterior / Q000378:metabolism*; D010911:Pituitary Neoplasms / Q000150:complications / Q000378:metabolism / Q000601:surgery*; D011184:Postoperative Period; D015175:Prolactinoma / Q000378:metabolism / Q000601:surgery; D012189:Retrospective Studies; D013961:Thyroid Gland / Q000503:physiopathology
D010908:Pituitary Hormones, Anterior; D019382:Human Growth Hormone; D006854:Hydrocortisone
Maladie de Cushing et adénome corticotrope: fonctions antéhypophysaires avant et après microchirurgie transsphénoïdale.