Cushing's Disease

Abstract:

Cushing's disease is caused by an adrenocorticotropin-producing tumor of the pituitary gland, causing hypercortisolism and Cushing's syndrome. Cushing's disease is the most common cause of Cushing's syndrome but can be very difficult to diagnose and to treat. Most pituitary adenomas causing Cushing's disease are small (<10. mm) and often difficult to find on imaging studies. Confirmation that the tumor resides in the pituitary and not at an ectopic site often requires an inferior petrosal sinus sample, in which the concentration of adrenocorticotropin in the pituitary venous effluent is compared to that in mixed venous blood. Transsphenoidal pituitary microsurgery, when performed by an experienced neurosurgeon, is curative in the majority of cases, but even at the best centers recurrence rates are high. Bilateral adrenalectomy is curative when pituitary surgery is not, and recent advances in medical therapy hold promise for improving outcomes. The long-term health and quality of life in patients with Cushing's disease remain suboptimal, despite even the most advanced care.

Año de publicación:

2014

Keywords:

• Pasireotide
• Transsphenoidal pituitary surgery
• Glucocorticoid
• Cushing's disease
• Adrenocorticotropin
• Pituitary adenoma
• Inferior petrosal sinus sampling
• Cushing's syndrome
• Hypercortisolism

Fuente:

scopus