open access

Vol 63, No 5 (2012)
Postgraduate education
Published online: 2012-10-31
Submitted: 2013-02-15
Get Citation

Cushing’s disease - assessing the efficacy of transsphenoidal surgery

Przemysław Witek, Grzegorz Zieliński, Maria Maksymowicz, Grzegorz Kamiński
Endokrynologia Polska 2012;63(5):398-404.

open access

Vol 63, No 5 (2012)
Postgraduate education
Published online: 2012-10-31
Submitted: 2013-02-15

Abstract

Cushing’s disease (CD) is caused by a pituitary adenoma secreting corticotrophin (ACTH) that leads to cortisol excess. Despite a characteristic clinical picture, it is often difficult to make a proper diagnosis, as it requires complex and long-lasting diagnostic procedures. Selective transsphenoidal surgery (TSS) remains the treatment of choice for CD. Untreated or improperly treated Cushing’s disease leads to the development of serious complications, which lower patients’ quality of life. Mortality in this group is high, reaching 50% within a 5-year follow-up period. In this study, we present our own experience and discuss the importance of preoperative hormone measurements, magnetic resonance imaging (MRI) of the pituitary, results of histopathological examination (immunohistochemical and ultrastructural in electron microscopy) and postoperative early and late hormonal assessment in the aspect of TSS efficacy. The performed analysis is based on the current criteria for remission of Cushing’s disease. Our study emphasises the need for long-term postoperative endocrinological follow-up, which facilitates early detection of recurrent hypercortisolemia. (Endokrynol Pol 2012; 63 (5): 398-403)

Abstract

Cushing’s disease (CD) is caused by a pituitary adenoma secreting corticotrophin (ACTH) that leads to cortisol excess. Despite a characteristic clinical picture, it is often difficult to make a proper diagnosis, as it requires complex and long-lasting diagnostic procedures. Selective transsphenoidal surgery (TSS) remains the treatment of choice for CD. Untreated or improperly treated Cushing’s disease leads to the development of serious complications, which lower patients’ quality of life. Mortality in this group is high, reaching 50% within a 5-year follow-up period. In this study, we present our own experience and discuss the importance of preoperative hormone measurements, magnetic resonance imaging (MRI) of the pituitary, results of histopathological examination (immunohistochemical and ultrastructural in electron microscopy) and postoperative early and late hormonal assessment in the aspect of TSS efficacy. The performed analysis is based on the current criteria for remission of Cushing’s disease. Our study emphasises the need for long-term postoperative endocrinological follow-up, which facilitates early detection of recurrent hypercortisolemia. (Endokrynol Pol 2012; 63 (5): 398-403)
Get Citation

Keywords

Cushing’s disease; desmopressin; pituitary adenoma; cortisol; transsphenoidal surgery; magnetic resonance; dexamethasone suppression test

About this article
Title

Cushing’s disease - assessing the efficacy of transsphenoidal surgery

Journal

Endokrynologia Polska

Issue

Vol 63, No 5 (2012)

Pages

398-404

Published online

2012-10-31

Bibliographic record

Endokrynologia Polska 2012;63(5):398-404.

Keywords

Cushing’s disease
desmopressin
pituitary adenoma
cortisol
transsphenoidal surgery
magnetic resonance
dexamethasone suppression test

Authors

Przemysław Witek
Grzegorz Zieliński
Maria Maksymowicz
Grzegorz Kamiński

Important: This website uses cookies.tanya dokter More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

Via MedicaWydawcą serwisu jest  "Via Medica sp. z o.o." sp.k., ul. Świętokrzyska 73, 80–180 Gdańsk

tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail:  viamedica@viamedica.pl