Comparisons between Macroadenomas and Microadenomas in Cushing's Disease: Characteristics of Hormone Secretion and Clinical Outcomes.
10.3346/jkms.2009.24.1.46
- Author:
You Cheol HWANG
1
;
Jae Hoon CHUNG
;
Yong Ki MIN
;
Myung Shik LEE
;
Moon Kyu LEE
;
Kwang Won KIM
Author Information
1. Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. kw1234@skku.edu
- Publication Type:Original Article ; Comparative Study
- Keywords:
Pituitary ACTH Hypersecretion;
Pituitary Adenoma;
Outcome Assessment (Health Care)
- MeSH:
Adenoma/complications/*metabolism/surgery;
Adolescent;
Adrenocorticotropic Hormone/blood/*secretion;
Adult;
Aged;
Dexamethasone/metabolism;
Female;
Humans;
Hydrocortisone/blood/*secretion;
Male;
Middle Aged;
Pituitary ACTH Hypersecretion/*diagnosis/etiology;
Pituitary Neoplasms/complications/*metabolism/surgery;
Retrospective Studies
- From:Journal of Korean Medical Science
2009;24(1):46-51
- CountryRepublic of Korea
- Language:English
-
Abstract:
It has been suggested that the patients with Cushing's disease secondary to pituitary macroadenomas (>10 mm) have higher basal adrenocorticotropic hormone (ACTH) levels, which are less suppressible on high-dose dexamethasone suppression tests (HDDST). We compared the clinical and biochemical characteristics of patients with macroadenomas (N=7) and microadenomas (N=23) who were diagnosed at Samsung Medical Center in Korea between 1996 and 2006. Basal morning plasma ACTH levels were 101.5+/-23.2 pg/mL for macroadenoma patients and 83.6+/-11.1 pg/mL for microadenoma patients (mean+/-SEMs) (p=0.44). Morning serum cortisol levels were 26.8+/-3.2 microgram/dL for macroadenoma patients and 29.5 +/-2.9 microgram/dL for microadenoma patients (p=0.77). The proportion of patients who showed suppressibility on HDDST was almost identical in the two groups (71.4% [5/7] for macroadenoma patients vs. 72.7% [16/22] for microadenoma patients, p=1.00). Furthermore, the remission rate with trans-sphenoidal surgery was similar between the two groups (100% [5/5] for macroadenoma patients vs. 73.3% [11/ 15] for microadenoma patients, p=0.53). Thus, tumor size is not a major determinant of hormone secretion or clinical outcomes in patients with Cushing's disease.
