title: Long-term remission of cyclic Cushing's disease that was diagnosed and treated surgically in non-active phase.
abstract: Cyclic Cushing's disease is a rare clinical entity that is defined as a periodic excessive production of adrenocorticotropic hormone (ACTH) and cortisol. Only 42 cases with cyclic Cushing's disease have been reported in the literature. The diagnosis is very difficult because of the fluctuating secretion of ACTH and cortisol. We report a 78-year-old woman with a pituitary adenoma presenting with cyclic Cushing's disease. In the present case, several interesting issues are pointed out: 1) MRI study detected the presence of an adenoma and selective venous sampling in the cavernous sinus disclosed the hypersecretion of ACTH from a pituitary adenoma. These neuroimaging and endocrinological studies were helpful for the diagnosis, even in the remission phase. 2) The disease was in the long-term remission phase after transsphenoidal surgery despite the high recurrence rate in this clinical entity, although it recurred four years later. Even in the remission phase of cyclic Cushing's disease, meticulous endocrinological and neuroimaging examinations can reveal the presence of a pituitary adenoma, which should be treated surgically.
authors: Department of Neurosurgery, Teikyo University Chiba Medical Center, Ichihara City, Japan.
authors: Shuichiro
authors: S
authors: Asano
authors: Hikaru
authors: H
authors: Ooka
authors: Ryo
authors: R
authors: Okazaki
authors: Toshio
authors: T
authors: Ishikawa
authors: Hiromi
authors: H
authors: Ochiai
authors: Michi
authors: M
authors: Nakashima
authors: Fuyuaki
authors: F
authors: Ide
authors: Isao
authors: I
authors: Hasegawa
authors: Satoru
authors: S
authors: Miyawaki
authors: Hiroshi
authors: H
authors: Nakaguchi
authors: Mineko
authors: M
authors: Murakami
authors: Yoshio
authors: Y
authors: Ogino
authors: Koji
authors: K
authors: Takano
authors: Akira
authors: A
authors: Matsuno
mesh_terms: D049913:ACTH-Secreting Pituitary Adenoma / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D000236:Adenoma / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D000324:Adrenocorticotropic Hormone / Q000097:blood; D000368:Aged; D018450:Disease Progression; D005260:Female; D006801:Humans; D010507:Periodicity; D047748:Pituitary ACTH Hypersecretion / Q000097:blood / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*; D012074:Remission Induction; D013997:Time Factors
chemical_list: D000324:Adrenocorticotropic Hormone