Surgical remission of pituitary adenomas confined to the neurohypophysis in Cushing's disease

The Journal of Clinical Endocrinology and Metabolism
Robert J WeilE H Oldfield

Abstract

Partial or total removal of the pituitary cures 60-80% of patients with Cushing's disease (CD) in whom an adenoma cannot be identified at surgery. Many patients who fail complete or partial hypophysectomy are cured by sellar and parasellar irradiation. As part of a series of prospective studies of CD, we identified 12 patients (34.5 +/- 19.9 yr; 11 females; four children) with tumors located completely within the neurohypophysis among 730 patients undergoing surgery for CD. The study was conducted at a tertiary referral center at a clinical research hospital. All 12 patients had clinical and biochemically defined CD. Tumor was visible at surgery in 11 patients; all 12 tumors were positive for ACTH by immunohistochemistry. Two tumors were excised at repeat surgery because of persistent hypercortisolism within 14 d of negative exploration of the adenohypophysis. There were no long-term complications. At follow-up of 71.9 +/- 34.2 months (range, 30-138 months), all patients are in remission of CD. Adult patients have had significant improvement in weight and body mass indices, with restoration of normal menses in all women. In the four pediatric patients, height, weight, and body mass indices have been restored toward normal by su...Continue Reading

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Citations

Dec 21, 2010·Pathology International·Fabio RotondoKalman Kovacs
Jul 29, 2010·Journal of Pediatric Endocrinology & Metabolism : JPEM·Monalisa F AzevedoConstantine A Stratakis
Mar 10, 2009·Journal of Neurosurgery·Jay JagannathanEdward H Oldfield
Feb 26, 2013·Journal of Neurosurgery·Andrew S Little, Kristina Chapple
Feb 2, 2013·European Journal of Endocrinology·Krystallenia I AlexandrakiAshley B Grossman
Jun 15, 2014·Endocrine·Philip C JohnstonAmir H Hamrahian
Mar 1, 2015·Pituitary·Robert F DallapiazzaJohn A Jane
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Jun 8, 2010·Journal of Neuro-oncology·Xin QuTao Song
Sep 15, 2021·Acta neurochirurgica·Bertrand Baussart, Stephan Gaillard
Oct 18, 2007·Current Opinion in Endocrinology, Diabetes, and Obesity

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