Pituitary Cushing's disease without adenoma

Area of Science:

• Endocrinology
• Neurosurgery
• Pathology

Background:

• Cushing's disease is typically caused by pituitary adenomas.
• The transsphenoidal route is a common surgical approach for pituitary tumors.

Observation:

• A patient with biochemically confirmed pituitary hypercortisolism underwent hypophysectomy.
• Post-surgery, the patient achieved clinical and biochemical remission.

Findings:

• Histological examination of the removed pituitary tissue revealed corticotroph cell hyperplasia.
• No pituitary adenoma was identified in the resected tissue.

Implications:

• This case suggests that a subset of Cushing's disease patients may have hyperplasia without adenoma.
• It broadens the understanding of pituitary pathologies causing Cushing's disease.
• Highlights the importance of considering hyperplasia in treatment-resistant or atypical cases.