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Cushing's disease: management by transsphenoidal pituitary microsurgery
The Journal of Clinical Endocrinology and Metabolism
|February 1, 1980
Summary
Transsphenoidal pituitary surgery effectively treats Cushing's disease in many patients. This approach achieved remission in 16 out of 24 patients, with resolution of hormonal imbalances and symptoms.
Area of Science:
- Neurosurgery
- Endocrinology
- Oncology
Background:
- Cushing's disease is a rare endocrine disorder caused by excess cortisol production.
- Transsphenoidal surgery is a primary treatment modality for pituitary adenomas causing Cushing's disease.
Purpose of the Study:
- To evaluate the efficacy and outcomes of transsphenoidal pituitary surgery for Cushing's disease.
- To assess factors influencing surgical success and complications.
Main Methods:
- Retrospective analysis of 24 patients undergoing transsphenoidal pituitary surgery over 15 years.
- Histopathological examination, electron microscopy, and immunochemical studies for tumor characterization.
- Assessment of clinical outcomes, hormonal normalization, and symptom resolution post-surgery.
Main Results:
- 16 out of 24 patients achieved remission, with varying degrees of sellar changes.
- Recurrence was observed in 2 patients; 3 patients with extensive sellar destruction were not cured.
- Tumor histology confirmed ACTH-producing basophilic adenomas.
- Resolution of symptoms like impotence, amenorrhea, and galactorrhea was noted in cured patients.
- Hemorrhage was the primary surgical complication in 3 patients.
Conclusions:
- Transsphenoidal pituitary surgery is a valuable and effective treatment for Cushing's disease.
- Sellar morphology and extent of tumor invasion may influence surgical outcomes.
- Successful surgery leads to hormonal normalization and symptom improvement.