title: Surgical management of recurrent Cushing's disease in pregnancy: A case report.
abstract: BACKGROUND
  Cushing's disease is a condition rarely encountered during pregnancy. It is known that hypercortisolism is associated with increased maternal and fetal morbidity and mortality. When hypercortisolism from Cushing's disease does occur in pregnancy, the impact of achieving biochemical remission on fetal outcomes is unknown. We sought to clarify the impact of successful surgical treatment by presenting such a case report.
  
  
  METHODS
  A 38-year-old pregnant woman with recurrent Cushing's disease after 8 years of remission. The patient had endoscopic transsphenoidal of her pituitary adenoma in her 18(th) week of pregnancy. The patient had postoperative biochemical remission and normal fetal outcome with no maternal complications.
  
  
  CONCLUSIONS
  Transsphenoidal surgery for Cushing's disease can be performed safely during the second trimester of pregnancy.
authors.affiliation: Rose Ella Burkhardt Brain Tumor and Neuro-oncology Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA ; Minimally Invasive Cranial Base and Pituitary Surgery Program, Cleveland Clinic, Cleveland, Ohio, USA.
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Abbassy
authors.affiliation: Rose Ella Burkhardt Brain Tumor and Neuro-oncology Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA ; Minimally Invasive Cranial Base and Pituitary Surgery Program, Cleveland Clinic, Cleveland, Ohio, USA.
authors.forename: Varun R
authors.initials: VR
authors.lastname: Kshettry
authors.affiliation: Department of Endocrinology, Diabetes, and Metabolism, Cleveland Clinic, Cleveland, Ohio, USA.
authors.forename: Amir H
authors.initials: AH
authors.lastname: Hamrahian
authors.affiliation: Department of Endocrinology, Diabetes, and Metabolism, Cleveland Clinic, Cleveland, Ohio, USA.
authors.forename: Philip C
authors.initials: PC
authors.lastname: Johnston
authors.affiliation: Department of Endocrinology, Diabetes, and Metabolism, Cleveland Clinic, Cleveland, Ohio, USA.
authors.forename: Georgianna A
authors.initials: GA
authors.lastname: Dobri
authors.affiliation: Department of Anesthesiology, Cleveland Clinic, Cleveland, Ohio, USA.
authors.forename: Rafi
authors.initials: R
authors.lastname: Avitsian
authors.affiliation: Rose Ella Burkhardt Brain Tumor and Neuro-oncology Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA ; Minimally Invasive Cranial Base and Pituitary Surgery Program, Cleveland Clinic, Cleveland, Ohio, USA ; Section of Skull Base Rhinology and Sinus Surgery, Head and Neck Institute, Cleveland Clinic, Cleveland, Ohio, USA.
authors.forename: Troy D
authors.initials: TD
authors.lastname: Woodard
authors.affiliation: Rose Ella Burkhardt Brain Tumor and Neuro-oncology Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA ; Minimally Invasive Cranial Base and Pituitary Surgery Program, Cleveland Clinic, Cleveland, Ohio, USA ; Section of Skull Base Rhinology and Sinus Surgery, Head and Neck Institute, Cleveland Clinic, Cleveland, Ohio, USA.
authors.forename: Pablo F
authors.initials: PF
authors.lastname: Recinos
keywords: Cushing's syndrome; endonasal; endoscopic; fetal complications; minimally invasive skull base surgery; operative timing; pituitary