[Cushing disease resistent to conventional therapy: role of bilateral laparoscopic adrenalectomy]

Cushing's disease is the most frequent form of endogenous hypercortisolism in the adult. It is a rare disease, whose natural history is not well known, and has a tremendous impact on patients' quality of life. Trans-sphenoidal surgery is the first therapeutic option in the management of these patients, but it is associated with a 25% long-term recurrence rate. Based on the observation of two patients, the Authors discuss the multidisciplinary approach, the indications and the timing of treatment by bilateral adrenalectomy. Also, the peculiar aspects of the laparoscopic surgical technique are outlined.