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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...
Adrenal Gland Disorders01:27

Adrenal Gland Disorders

Adrenal gland disorders manifest when the production of adrenal hormones deviates from the norm, resulting in either excessive or insufficient concentrations.
Adrenal insufficiency, characterized by insufficient cortisol and aldosterone production, leads to conditions like Addison's disease. This disorder, affecting the adrenal cortex, exhibits symptoms such as skin bronzing, dehydration, low blood pressure, fatigue, and weight loss. Congenital adrenal hyperplasia, a genetic ailment causing...
Chronic Pancreatitis II: Collaborative Care01:29

Chronic Pancreatitis II: Collaborative Care

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Assessment:
Cystic Fibrosis: Management01:24

Cystic Fibrosis: Management

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Chronic Obstructive Pulmonary Disease-V: Management

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Smoking Cessation

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Related Experiment Video

Updated: Jun 4, 2026

Full-Endoscopic Surgery for Hypothalamic Hamartoma Resection
02:22

Full-Endoscopic Surgery for Hypothalamic Hamartoma Resection

Published on: April 12, 2024

Management of Cushing disease.

Nicholas A Tritos1, Beverly M K Biller, Brooke Swearingen

  • 1Neuroendocrine Unit, Zero Emerson Place, Suite 112, Massachusetts General Hospital, Boston, MA 02114, USA. ntritos@partners.org

Nature Reviews. Endocrinology
|February 9, 2011
PubMed
Summary

Cushing disease, a pituitary tumor condition, is primarily treated with surgery. However, recurrence is common, necessitating alternative treatments like repeat surgery, radiation, or adrenalectomy for persistent cases.

Area of Science:

  • Endocrinology
  • Neurosurgery
  • Oncology

Background:

  • Cushing disease results from a pituitary corticotroph tumor, leading to hypercortisolism.
  • Transsphenoidal surgery offers high remission rates (70-90%) but carries a 20-25% risk of recurrence within 10 years.

Purpose of the Study:

  • To review treatment options for persistent or recurrent Cushing disease after initial surgery.
  • To discuss the efficacy and risks of secondary treatments including repeat surgery, radiation, and adrenalectomy.

Main Methods:

  • Literature review of treatment modalities for Cushing disease.
  • Analysis of remission rates, morbidity, and long-term outcomes for various therapeutic approaches.

Main Results:

Related Experiment Videos

Last Updated: Jun 4, 2026

Full-Endoscopic Surgery for Hypothalamic Hamartoma Resection
02:22

Full-Endoscopic Surgery for Hypothalamic Hamartoma Resection

Published on: April 12, 2024

  • Second transsphenoidal surgery achieves remission in 50-70% of persistent/recurrent cases.
  • Pituitary radiation therapy offers high remission rates (∼85%) but has a long latency period, often requiring interim medical management.
  • Bilateral adrenalectomy provides rapid hypercortisolism control but requires lifelong hormone replacement and carries a risk of Nelson syndrome.

    • Conclusions:

    • Management of persistent or recurrent Cushing disease requires careful consideration of treatment risks and benefits.
    • Emerging medical therapies may offer new avenues for managing this complex endocrine disorder.