Persistent Cushing ’s Disease after Transsphenoidal Surgery: Challenges and Solutions
Exp Clin Endocrinol Diabetes DOI: 10.1055/a-1220-6056Transsphenoidal surgery remains the primary treatment for Cushing’s
disease (CD). However, despite the vast improvements in pituitary surgery,
successful treatment of CD remains a great challenge. Although selective
transsphenoidal removal of the pituitary tumor is a safe and effective
procedure, the disease persists in around 22% of CD patients due to
incomplete tumor resection. The persistence of hypercortisolism after pituitary
surgery may also be the consequence of a misdiagnosis, as can occur in case of
ectopic ACTH secretion or pseudo-Cushing. Considering the elevated mortality and
morbidity characterizing the disease, a multidisciplinary approach is needed to
minimize potential pitfalls occurring during the diagnosis, avoid surgical
failure and provide the best care in those patients who have undergone
unsuccessful surgery. In this review, we analyze the factors that could predict
remission or persistence of CD after pituitary surgery and revise the
therapeutic options in case of surgical failure. [...] © Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals: Table of contents | Abstract | Full text
Source: Experimental and Clinical Endocrinology and Diabetes - Category: Endocrinology Authors: Albani, Adriana Theodoropoulou, Marily Tags: Article Source Type: research