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Cushing's disease. A review.

Archives of Internal Medicine

|June 1, 1985

Summary

This summary is machine-generated.

Transsphenoidal microsurgery (TPS) offers a high cure rate for Cushing's disease by removing ACTH-secreting adenomas. Postoperative hypoadrenalism is a key indicator of successful surgical outcomes for this pituitary disorder.

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Area of Science:

Endocrinology
Neurosurgery
Oncology

Background:

Cushing's syndrome presents diagnostic challenges for clinicians.
Pituitary-dependent adrenal hyperplasia, or Cushing's disease, requires careful management.
Recent experiences at Duke University provide insights into Cushing's disease.

Purpose of the Study:

To review the pathophysiology, etiology, and management of Cushing's disease.
To present recent experiences with Cushing's disease at Duke University.
To evaluate the role of transsphenoidal microsurgery in treating Cushing's disease.

Main Methods:

Review of recent clinical experiences with Cushing's disease.
Analysis of outcomes following transsphenoidal microsurgery (TPS).

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Evaluation of postoperative hypoadrenalism as a marker of cure.

Main Results:

Transsphenoidal microsurgery (TPS) provides selective adenoma removal and immediate cure of hypercortisolism.
TPS preserves pituitary function with minimal morbidity.
Postoperative hypoadrenalism is a reliable indicator of surgical success.

Conclusions:

Transsphenoidal surgery has significantly advanced the understanding and treatment of Cushing's disease.
While TPS is highly effective, radiotherapy, adrenalectomy, and drug therapy remain options for treatment failures or recurrences.
Continued research is needed to optimize management strategies for Cushing's disease.