The Results of Transsphenoidal Microsurgery for Pituitary Microadenama in Cushing's Disease.
- Author:
Yun Yong LEE
1
;
Jin Seong KIM
;
Byeong Sul MUN
;
Chan Soo SHIN
;
Seong Yeon KIM
;
Bo Youn CHO
;
Hong Kyu LEE
;
Chang Soon KOH
;
Hee Won JOENG
;
Dae Hee HAN
;
Moom Hee HAN
;
Kee Hyun CHANG
Author Information
1. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Cushing's disease;
Pituitary microadenoma;
Transsphenoidal microsurgery
- MeSH:
Adenoma;
Adrenocorticotropic Hormone;
Female;
Follow-Up Studies;
Humans;
Male;
Microsurgery*;
Pituitary Gland;
Recurrence;
Retrospective Studies;
Seoul
- From:Korean Journal of Medicine
1997;53(6):811-816
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Cushing's disease is a hypercortisolic state attributable to hypersecretion of ACTH at pituitary gland Most of these diseases are due to pituitary microadenoma. Selective removal of adenoma by transsphenoidal microsurgery is the treatment of choice for Cushing's disease. We evaluated 25 cases to analyze results of transsphenoidal microsurgery and to identify prognostic factors that may predict successful outcome. METHODS: From 1989 to 1995, 25 patients were diagnosed as having Cushing's disease in Seoul National University Hospital. They were underwent pituitary microsurgery and confirmed to have pituitary microadenoma radiologically and pathologically. About these patients. retrospective evaluation was done. RESULTS: The patients consist of 21 females and 4 males and the age was ranged from 23 to 49 years. 19 patients (76%) were judged as immediate remission. The preoperative clinical, hormonal, and radiological characteristics of the remission and failure groups were similiar The patients who were immediate remission were followed from 3 months to 72 months. 3 patients had recurrences(15.8%) at 4, 8, 49 months after operation. The pre and postoperative clinical, hormonal, and radiological characteristics of the long-term remission and recurrence groups were similiar. We could not find any predictable factors of surgical outcome. CONCLUSION: The first line trearment of Cushing's disease is transsphenoidal microsurgery. However considering relative late and high rate of recurrence of Cushing's disease following curative surgery, careful longterm follow up is mandatory.
