Nelson's syndrome -- 46 years later: clinical experience with 37 patients

Zentralblatt für Neurochirurgie
A A Kasperlik-ZałuskaZ Czernicki

Abstract

Pituitary tumours occurring after bilateral adrenalectomy for Cushing's disease (Nelson's syndrome) are frequently aggressive, so an early diagnosis and careful management are of prime importance. For a new insight into this entity it is necessary to analyse the factors predisposing to its development and the course of the disease, as well as the methods of diagnosis and modalities of treatment. Thirty-seven patients with Nelson's syndrome were observed, 32 women and 5 men, aged 16 to 61 years at the time of pituitary tumour detection (at present, 27 to 82 years old). The diagnostic methods included clinical observation, imaging examinations (X-ray studies, CT, MRI), hormonal evaluation (especially ACTH and cortisol levels during replacement therapy) and ophthalmologic investigations. Neurosurgery was the main method of treatment. The clinical analysis indicated that young age at the time of adrenalectomy, pregnancy, insufficient replacement therapy and fulminant course of Cushing's disease were the main factors predisposing to Nelson's syndrome. MRI appeared to be the most valuable imaging method, as this detected Nelson's tumours in the microadenoma stage in 7 patients. Plasma ACTH levels varied between 32.6 pmol/l in an earl...Continue Reading

Citations

Oct 27, 2007·Neurosurgical Focus·Mark HornyakWilliam T Couldwell
Oct 27, 2007·Neurosurgical Focus·Magdalena J Banasiak, Ali R Malek
Jan 14, 2017·Journal of Neurosurgery·Christopher S GraffeoJamie J Van Gompel
Jul 30, 2010·European Journal of Endocrinology·T M BarberJ A H Wass
Nov 19, 2019·The Journal of Clinical Endocrinology and Metabolism·Athanasios FountasNiki Karavitaki
Jun 13, 2015·Endocrine Reviews·Rosario PivonelloAnnamaria Colao
Aug 20, 2020·Expert Review of Endocrinology & Metabolism·Cristina CapatinaMaria Fleseriu
Jul 5, 2019·Archives of Endocrinology and Metabolism·Ana C CohenOscar D Bruno
Mar 1, 2010·Expert Review of Endocrinology & Metabolism·Anna A Kasperlik-Załuska

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