Surgical management of Cushing's disease.
BACKGROUND
Transsphenoidal selective adenomectomy is the first-line treatment for Cushing's disease. At experienced centers, early remission rates after transsphenoidal surgery range from 65 to 98%, however disease relapse frequently occurs with rates ranging from 2 to 35% at long-term follow up.


METHODS
This article discusses recently reported studies on the surgical outcomes from transsphenoidal surgery for Cushing's disease.


CONCLUSIONS
One of the keys to a successful long-term surgical outcome is meticulous dissection using the adenoma's pseudocapsule as a surgical plane for complete resection. MRI-negative and invasive ACTH-secreting adenomas pose particular challenges for pituitary surgeons.
Department of Neurosurgery, University of Virginia, PO Box 800212, Charlottesville, VA, 22908-0711, USA, rd4pm@virginia.edu.
Robert F
RF
Dallapiazza
Edward H
EH
Oldfield
John A
JA
Jane
D049913:ACTH-Secreting Pituitary Adenoma / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D000236:Adenoma / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D007016:Hypophysectomy; D009364:Neoplasm Recurrence, Local; D018365:Neoplasm, Residual; D047748:Pituitary ACTH Hypersecretion / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome