Therapy of Cushing Disease: A Consensus for Pituitary Microsurgery

Editorials15 September 1988Therapy of Cushing Disease: A Consensus for Pituitary MicrosurgeryJames C. Melby, MDJames C. Melby, MDAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-109-6-445 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTranssphenoidal pituitary adenomectomy has emerged as the primary treatment of choice for Cushing disease. The overall cure rate of histologically proved pituitary tumors approaches 90% in the hands of skilled neurosurgeons as has been shown in the major series of 221 patients described by Mampalam and colleagues (1) in this issue. The remarkable success of this procedure has also been observed in 91% of 228 patients studied at the Mayo Clinic over the past 11 years (2; Laws EJ. Personal communication). When no pituitary adenoma can be found histologically the cure rate falls to slightly less than 60%. Extrasellar extension...References1. Mampalam T, Tyrrell J, and Wilson C. Transsphenoidal microsurgery for Cushing disease: a report of 216 cases. Ann Intern Med. 1988;109:487-493. LinkGoogle Scholar2. Young W, Scheithauer B, Gharib H, Laws E, and Carpenter P. Cushing's syndrome due to primary multinodular corticotrope hyperplasia. Mayo Clin Proc. 1988;63:256-62. CrossrefMedlineGoogle Scholar3. Cushing H. The basophil adenomas of the pituitary body and their clinical manifestation (pituitary basophilism). Bull Johns Hopkins Hosp. 1932;50:137-95. Google Scholar4. Eisenhardt L and Thompson K. A brief consideration of the present status of so-called pituitary basophilism: with a tabulation of verified cases. Yale J Biol Med. 1938-1939;11:507-22. Google Scholar5. Hardy J. Transsphenoidal microsurgery of the normal and pathological pituitary. Clin Neurosurg. 1969;16:185-217. CrossrefMedlineGoogle Scholar6. Salassa R, Laws E, Carpenter P, and Northcutt R. Transsphenoidal removal of pituitary microadenoma in Cushing's disease. 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Schrell U, Fahlbusch R, Buchfelder M, Riedl S, Stalla G, and Müller O. Corticotropin-releasing hormone stimulation test before and after transsphenoidal selective microadenomectomy in 30 patients with Cushing's disease. J Clin Endocrinol Metab. 1987;64:1150-9. CrossrefMedlineGoogle Scholar12. Styne D, Grumbach M, Kaplan S, Wilson C, and Conte F. Treatment of Cushing's disease in childhood and adolescence by transsphenoidal microadenomectomy. N Engl J Med. 1984;310:889-93. CrossrefMedlineGoogle Scholar13. Kjellberg R, Bliman B, Swisher B, and Butler B. Proton beam therapy of Cushing's disease and Nelson's syndrome. In: Black PM, et al. Secretory Tumors of the Pituitary Gland. New York:Raven Press;1984:295. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: James C. 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Kaye, MD, Lawrence Crapo, MDCushing's disease: results of transsphenoidal microsurgery with emphasis on surgical failuresCushing's SyndromePituitary Tumors 15 September 1988Volume 109, Issue 6Page: 445-446KeywordsFallsNeurosurgeryPituitary tumors ePublished: 1 December 2008 Issue Published: 15 September 1988 PDF downloadLoading ...