Therapeutic options after surgical failure in Cushing's disease: A critical review

Publication date: Available online 16 April 2019Source: Best Practice & Research Clinical Endocrinology & MetabolismAuthor(s): German Rubinstein, Andrea Osswald, Stephanie Zopp, Katrin Ritzel, Marily Theodoropoulou, Felix Beuschlein, Martin ReinckeCushing's disease (CD) is the most common etiology of Cushing's syndrome (CD) due to corticotroph pituitary adenoma, which are in most cases small (80–90% microadenomas) and in about 40% cannot be visualized on imaging of the sella. First-line treatment for CD is transsphenoidal surgery (TSS) with the aim of complete adenoma removal and preservation of pituitary gland function. As complete adenoma resection is not always possible, surgical failure is a common problem. This can be the case either due to persistent hypercortisolism after first TSS or recurrence of hypercortisolism after initially achieving remission. For these scenarios exist several therapeutic options with their inherent characteristics, which will be covered by this review.
Source: Best Practice and Research Clinical Endocrinology and Metabolism - Category: Endocrinology Source Type: research