Cushing's disease. Therapy of pituitary adenomas

Treatment of Cushing's disease has evolved over the past 20 years from the era of bilateral adrenalectomy to the current era of pituitary microsurgery. Therapy directed to the pituitary gland is currently the first approach in Cushing's disease and transphenoidal exploration of the sellar contents is the procedure of choice. Tumor localization and pituitary surgery are reviewed. Pituitary radiotherapy, pharmacologic inhibition of ACTH secretion, and Nelson's syndrome are also discussed.