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Related Concept Videos

Cushing Syndrome I: Introduction01:26

Cushing Syndrome I: Introduction

Cushing syndrome refers to the collection of clinical manifestations that arise when tissues are exposed to excessive amounts of cortisol or cortisol-like medications over an extended period. Cortisol, a glucocorticoid produced by the adrenal cortex, regulates metabolism, immune responses, and the body’s adaptation to stress. When its concentration remains chronically elevated, these physiological pathways become dysregulated, resulting in the characteristic features of the syndrome.Exogenous...
Cushing Syndrome II: Pathophysiology01:19

Cushing Syndrome II: Pathophysiology

Cortisol production is normally governed by the hypothalamic–pituitary–adrenal (HPA) axis, which maintains hormonal balance through tightly regulated feedback mechanisms. Disruption of this regulatory system is central to the development of Cushing syndrome, whether the excess cortisol originates from external medications or internal pathology. Persistent cortisol elevation alters metabolism, immune function, and endocrine signaling, producing the characteristic clinical features of the...

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Related Experiment Video

Updated: Jun 23, 2026

Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
07:43

Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas

Published on: January 17, 2018

Long-term mortality after transsphenoidal surgery for Cushing disease.

B Swearingen1, B M Biller, F G Barker

  • 1Neurosurgical Service, Massachusetts General Hospital and Harvard Medical School, Boston 02114, USA.

Annals of Internal Medicine
|June 12, 1999
PubMed
Summary

Long-term survival for Cushing disease patients treated with transsphenoidal surgery is significantly improved. Modern management techniques offer better outcomes than historically poor survival rates associated with this condition.

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Area of Science:

  • Endocrinology
  • Neurosurgery
  • Oncology

Background:

  • Cushing disease historically has a high mortality rate when untreated.
  • Long-term survival data post-transsphenoidal surgery for Cushing disease is limited.

Purpose of the Study:

  • To determine the long-term mortality rate in patients treated for Cushing disease using current management techniques.
  • Evaluate survival outcomes following transsphenoidal adenomectomy.

Main Methods:

  • Retrospective case series of 161 patients (1978-1996) treated at a tertiary care center.
  • Transsphenoidal adenomectomy with as-needed adjunctive therapy.
  • Data collected via record review and follow-up interviews.

Main Results:

  • 90% cure rate for previously untreated microadenomas.
  • No perioperative deaths occurred in 193 procedures.
  • 5- and 10-year survival rates were 99% and 93%, respectively, comparable to the general population.

Conclusions:

  • Current management techniques for Cushing disease significantly improve patient survival.
  • Transsphenoidal surgery offers better long-term outcomes compared to historical data.
  • Improved survival rates demonstrate the efficacy of modern treatment approaches.