Management of recurrent and refractory Cushing disease.

Manish K Aghi

Journal: Nature clinical practice. Endocrinology & metabolism 2008;4(10):560-8

PMID: 18711406

Abstract

Cushing disease is most frequently caused by pituitary adenomas that secrete adrenocorticotrophic hormone. Transsphenoidal surgery is the treatment of choice in patients with these tumors because of reported remission rates of 69-93%. More challenging for neurosurgeons and endocrinologists, however, is management of the remaining patients whose Cushing disease is refractory to initial transsphenoidal surgery or recurs after initial remission. Here, we review the treatment options and latest surgical, medical, and radiosurgical advances for patients who have persistent or recurrent Cushing disease after transsphenoidal surgery.

Address: Neurological Surgery, The California Center for Pituitary Disorders, University of California, San Francisco (UCSF), CA 94143-0112, USA. [email protected]

DOI: 10.1038/ncpendmet0947

MeSH Terms: ACTH-Secreting Pituitary Adenoma, Adrenalectomy, Humans, Hypophysectomy, Ketoconazole, Models, Biological, Neoplasm Recurrence, Local, Pituitary ACTH Hypersecretion, Pituitary Neoplasms, Radiosurgery, Recurrence, Sphenoid Bone, Treatment Failure