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Updated: May 8, 2026
Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
Repeated transsphenoidal surgery or gamma knife radiosurgery in recurrent cushing disease after transsphenoidal
Mohammad Bodaghabadi1, Hooman Riazi2, Shima Aran3
1Department of Neuroradiosurgery, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran.
Background:
This study compared Gamma knife radiosurgery (GKRS) and repeated transsphenoidal adenomectomy (TSA) to find the best approach for recurrence of Cushing disease (CD) after unsuccessful first TSA.
Material And Methods:
Fifty-two patients with relapse of CD after TSA were enrolled and randomly underwent a second surgery or GKRS as the next therapeutic approach. They were followed for a mean period of 3.05 ± 0.8 years by physical examination and hormone measurement as well as magnetic resonance imaging.
Results:
No significant difference was observed in sex ratio, mean age, adenoma type, follow-up duration, and initial hormone level between the two groups. No significant relationship was found between preoperative 24-hour free urine cortisol and disease-free months or tumor volume among both groups. Our statistical analysis showed higher recurrence-free interval in the GKRS group compared with TSA group.
Conclusion:
With longer recurrence-free interval, GKRS could be considered a good treatment alternative to repeated TSA in recurrent CD.
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