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How to manage Cushing's disease after failed primary pituitary surgery.
Eur J Endocrinol
August 2024
Department of Internal Medicine, Division of Endocrinology, Erasmus MC, 3015 GD Rotterdam, Netherlands.
Article Synopsis
- * If the initial surgery fails, options for second-line treatment include additional surgeries, medication, or radiation.
- * Recent advancements in medical therapy have introduced new drugs targeting the pituitary gland and cortisol production, with bilateral adrenalectomy being a more extreme option for persistent cases.
Subclinical Cushing's Disease with High-Molecular-Weight Forms of Adrenocorticotropic Hormone Production.
Case Rep Endocrinol
March 2024
Department of Diabetes and Endocrinology, University of Yamanashi Hospital, Yamanashi, Japan.
Production of the high-molecular-weight forms of adrenocorticotropic hormone (big-ACTH) has been reported in a small number of ectopic ACTH syndrome and ACTH-producing pituitary macroadenoma. However, perioperative changes in big-ACTH in patients with subclinical Cushing's disease have not been reported. A 63-year-old woman presented 25 × 20 × 20-mm-sized macroadenoma in the pituitary gland.
View Article and Find Full Text PDFPerioperative growth hormone levels as an early predictor of new-onset secondary adrenal insufficiency following transsphenoidal pituitary tumor resection.
Asian J Surg
April 2024
Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan; Department of Biological Science and Technology, College of Biological Science and Technology, National Yang Ming Chiao Tung University, Hsinchu, Taiwan; Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital Hsinchu Branch, Hsinchu, Taiwan. Electronic address:
Objective: This study aims to predict new-onset secondary adrenal insufficiency (NOSAI) after transsphenoidal pituitary tumor resection surgery using perioperative growth hormone (GH) and prolactin (PRL) levels, among other factors.
Methods: A cohort of 124 adult patients who underwent transsphenoidal resection for non-functioning pituitary adenoma, with routine perioperative glucocorticoid use, was used to develop the predictive regression model. An additional 46 patients served as the validation cohort.
Inferior Petrosal Sinus Sampling Tumor Lateralization and the Surgical Treatment of Cushing Disease: A Meta-Analysis and Systematic Review.
World Neurosurg
February 2024
Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA. Electronic address:
Objective: To determine whether accurate inferior petrosal sinus sampling (IPSS) tumor lateralization is associated with improved clinical outcomes following the surgical treatment of Cushing disease.
Methods: The presented study was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Data regarding patient demographics, IPSS tumor lateralization, and postoperative endocrinologic outcomes were abstracted and pooled with random effects meta-analysis models.
Pituitary adenoma consistency affects postoperative hormone function: a retrospective study.
BMC Endocr Disord
April 2023
Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy.
Article Synopsis
- Tumor consistency is an important factor in planning surgeries for pituitary adenomas and may influence postoperative endocrine function.
- A study evaluated 50 patients and found that greater tumor volume and male sex were linked to worse preoperative endocrine function.
- Fibrous tumors were associated with higher risks of postoperative hormone deficiencies and lower resection rates compared to other tumor types.
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