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Therapeutic options after surgical failure in Cushing's disease: A critical review


Rubinstein, German; Osswald, Andrea; Zopp, Stephanie; Ritzel, Katrin; Theodoropoulou, Marily; Beuschlein, Felix; Reincke, Martin (2019). Therapeutic options after surgical failure in Cushing's disease: A critical review. Best Practice & Research. Clinical Endocrinology & Metabolism, 33(2):101270.

Abstract

Cushing's disease (CD) is the most common etiology of Cushing's syndrome (CD) due to corticotroph pituitary adenoma, which are in most cases small (80-90% microadenomas) and in about 40% cannot be visualized on imaging of the sella. First-line treatment for CD is transsphenoidal surgery (TSS) with the aim of complete adenoma removal and preservation of pituitary gland function. As complete adenoma resection is not always possible, surgical failure is a common problem. This can be the case either due to persistent hypercortisolism after first TSS or recurrence of hypercortisolism after initially achieving remission. For these scenarios exist several therapeutic options with their inherent characteristics, which will be covered by this review.

Abstract

Cushing's disease (CD) is the most common etiology of Cushing's syndrome (CD) due to corticotroph pituitary adenoma, which are in most cases small (80-90% microadenomas) and in about 40% cannot be visualized on imaging of the sella. First-line treatment for CD is transsphenoidal surgery (TSS) with the aim of complete adenoma removal and preservation of pituitary gland function. As complete adenoma resection is not always possible, surgical failure is a common problem. This can be the case either due to persistent hypercortisolism after first TSS or recurrence of hypercortisolism after initially achieving remission. For these scenarios exist several therapeutic options with their inherent characteristics, which will be covered by this review.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Endocrinology and Diabetology
Dewey Decimal Classification:610 Medicine & health
Scopus Subject Areas:Health Sciences > Endocrinology, Diabetes and Metabolism
Life Sciences > Endocrinology
Language:English
Date:16 April 2019
Deposited On:05 Jul 2019 13:30
Last Modified:29 Jul 2020 10:55
Publisher:Elsevier
ISSN:1521-690X
OA Status:Closed
Publisher DOI:https://doi.org/10.1016/j.beem.2019.04.004
PubMed ID:31036383

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