Skip to main content
SpringerLink
Log in

Diagnosis, treatment and postoperative results of Cushing's disease

  • Trends in pituitary surgery
  • Published:
Neurosurgical Review Aims and scope Submit manuscript

Summary

One hundred patients with Cushing's disease were operated on in Nagoya University Hospital between January 1977 and January 1984. Pituitary adenomas were found and resected in 93 cases and complete clinical remissions were observed in 89 treated by operation alone and in two additional cases by operation followed with radiotherapy. The clinical features, pre-operative endocrine data, radiological findings including high resolution CT with coronal and sagittal reconstructions, data of selective venous sampling, operative findings, tumour pathology, postoperative clinical course, postoperative endocrine results and follow-up findings are presented and discussed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Ambrosi, B., M. Giovanelli, S. M. Gaini, D. Bochicchio, E. Riva, G. Tomei, M. Zavanone, G. Faglia: Pituitary function before and after trans-sphenoidal adenomectomy in patients with Cushing's disease. Acta Neurochir. (Wien) 65 (1982) 29–40

    Google Scholar 

  2. Baggan, J. E., J. B. Tyrrell, C. B. Wilson: Transsphenoidal microsurgical management of Cushing's disease. J. Neurosurg. 59 (1983) 195–200

    PubMed  Google Scholar 

  3. Bigos, S. T., F. Robert, G. Pelletier, J. Hardy: Cure of Cushing's disease by trans-sphenoidal removal of a microadenoma from a pituitary gland despite a radiographically normal sella turcica. J. Clin. Endocrinol. Metab. 45 (1977) 1251–1260

    PubMed  Google Scholar 

  4. Burch, W.: A survey of results with trans-sphenoidal surgery in Cushing's disease. N. Eng. J. Med. 308 (1983) 103–104

    Google Scholar 

  5. Cassar, J., F. H. Doyle, K. Mashiter, G. F. Joplin: Treatment of Cushing's disease in juveniles with interstitial pituitary irradiation. Clin. Endocrinol. 11 (1979) 313–321

    Google Scholar 

  6. Couzinet, B., P. Thomopoulos, G. Schaison: Durable remission of Cushing's disease after OP'DDD treatment. Acta Endocrinol. 100 (1982) 63–67

    Google Scholar 

  7. Drury, P. L., S. Ratter, S. Tomlin, J. Williams, J. Dacie, L. H. Rees, G. M. Besser: Experience with selective venous sampling in diagnosis of ACTH-dependent Cushing's syndrome. Br. Med. J. 284 (1982) 9–12

    Google Scholar 

  8. D'Ercole, A. J., M. A. Morris, L. E. Underwood, J. J. Van Wyk: Treatment of Cushing's disease in childhood with cyproheptadine. J. Pediatrics 90 (1977) 834–835

    Google Scholar 

  9. Findling, J. W., D. C. Aron, J. B. Tyrrell, J. H. Shinsako, P. A. Fitzgerald, D. Normann, C. B. Wilson, P. H. Forsham: Selective venous sampling for ACTH in Cushing's syndrome. Ann. Int. Med. 94 (1981) 647–652

    PubMed  Google Scholar 

  10. Hardy, J.: Trans-sphenoidal surgery of hypersecreting pituitary tumours. In: Kohler, P. O. and G. T. Ross: Diagnosis and Treatment of Pituitary Tumours. pp. 170–194. Excerpta Medica, Am. Els., New York 1973

    Google Scholar 

  11. Jeffcoate, W. J., L. H. Rees, S. Tomlin, A. E. Jones, C. R. W. Edwards, G. M. Besser: Metyrapone in longterm management of Cushing's disease. Br. Med. J. 2 (1977) 215–217

    PubMed  Google Scholar 

  12. Jennings, A. S., G. W. Liddle, D. N. Orth: Results of treating childhood Cushing's disease with pituitary irradiation. N. Eng. J. Med. 297 (1977) 957–962

    Google Scholar 

  13. Kageyama, N., A. Kuwayama, M. Watanabe, T. Nakane, T. Takahashi, N. Kanie: Trans-sphenoidal microadenomectomy in cases of Cushing's disease. Nagoya J. Med. Sci. 45 (1983) 61–70

    PubMed  Google Scholar 

  14. Kley, H. K., T. Stolze, H. L. Kruskemper: Jugularvein sampling of ACTH. N. Engl. J. Med. 297 (1977) 731

    Google Scholar 

  15. Krieger, D. T., L. Amorosa, F. Linick: Cyproheptadine-induced remission of Cushing's disease. N. Eng. J. Med. 293 (1975) 893–896

    Google Scholar 

  16. Kuwayama, A., N. Kageyama, T. Nakane, M. Watanabe, N. Kanie: Anterior pituitary function after trans-sphenoidal selective adenomectomy in patients with Cushing's disease. J. Clin. Endocrinol. Metab. 53 (1981) 165–173

    PubMed  Google Scholar 

  17. Lagerquist, L. G., A. W. Meikle, C. D. West, F. H. Tyler: Cushing's disease with cure by resection of a pituitary adenoma. Am. J. Med. 57 (1974) 826–830

    PubMed  Google Scholar 

  18. Lamberts, S. W. J., S. Lange, S. Z. Stefanko: Adrenocorticotropin-secreting pituitary adenomas originate from the anterior or the intermediate lobe in Cushing's disease; Differences in the regulation of hormone secretion. J. Clin. Endocrinol. Metab. 54 (1982) 286–291

    PubMed  Google Scholar 

  19. Liddle, G. W.: Test of pituitary-adrenal suppressibility in the diagnosis of Cushing's syndrome. J. Clin. Endocrinol. Metab. 20 (1960) 1539–1560

    PubMed  Google Scholar 

  20. Lüdecke, D., R. Kautzky, W. Saeger: Selective removal of hypersecreting pituitary adenomas? An analysis of endocrine function, operative and microscopical findings in 101 cases. Acta Neurochir. (Wien) 35 (1976) 27–42

    Google Scholar 

  21. Manni, A., R. F. Latshow, R. Page, R. J. Santen: Simultaneous bilateral venous sampling for adrenocorticotropin in pituitary-dependent Cushing's disease. Evidence for lateralization of pituitary venous drainage. J. Clin. Endocrinol. Metab. 57 (1983) 1070–1073

    PubMed  Google Scholar 

  22. Orth, D. N., G. W. Liddle: Results of treatment in 108 patients with Cushing's syndrome. N. Eng. J. Med. 285 (1971) 243–247

    Google Scholar 

  23. Orth, D. N.: Metyrapone is useful only as adjunctive therapy in Cushing's disease. Ann. Int. Med. 89 (1978) 128–130

    PubMed  Google Scholar 

  24. Salassa, R. M., E. R. Jr. Laws, P. C. Carpenter, R. C. Norhcutt: Trans-sphenoidal removal of pituitary microadenoma in Cushing's disease. Mayo Clin. Proc. 53 (1978) 25–28

    Google Scholar 

  25. Schnall, A. M., K. Kovacs, J. S. Brodkey, O. H. Pearson: Pituitary Cushing's disease without adenoma. Acta Endocrinol. 94 (1980) 297–303

    PubMed  Google Scholar 

  26. Suda, T., H. Demura, R. Demura, K. Sibiki, F. Tozawa, K. Shizume: Anterior pituitary hormones in plasma and pituitaries from patients with Cushing's disease. J. Clin. Endocrinol. Metab. 51 (1980) 1048–1053

    PubMed  Google Scholar 

  27. Takahashi, T., A. Kuwayama, T. Kato, K. Ichihara, K. Nakamura: Thin-section CT of Cushing's disease. Prog. Comput. Tomogr. 3 (1983) 515–525

    Google Scholar 

  28. Thomas, J. P., S. H. Richards: Long-term results of radical hypophysectomy for Cushing's disease. Clin. Endocrinol. 19 (1983) 629–636

    Google Scholar 

  29. Tyrrell, J. B., R. M. Brooks, P. A. Fitzgerald, P. B. Cofoid, P. H. Forsham, C. B. Wilson: Cushing's disease; Selective trans-sphenoidal resection of pituitary microadenomas. N. Engl. J. Med. 298 (1978) 753–758

    PubMed  Google Scholar 

  30. Styne, D. M., M. M. Grumbach, S. L. Kaplan, C. B. Wilson, F. A. Conte: Treatment of Cushing's disease in childhood and adolescence by trans-sphenoidal microadenomectomy. N. Eng. J. Med. 14 (1984) 889–920

    Google Scholar 

  31. Wajchenberg, B. L., A. A. Silveira, J. Goldman, F. P. Cesar, R. Jr. Marino, S. S. Lima: Evaluation of resection of pituitary microadenoma for the treatment of Cushing's disease in patients with radiologically normal sella turcica. Clin. Endocrinol. 11 (1979) 323–331

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurosurgery, Nagoya University School of Medicine, 65 Tsuruma-cho, Showa-ku, 466, Nagoya, Japan

    Naoki Kageyama, Akio Kuwayama, Tatsuo Takahashi, Makoto Negoro & Kaoru Ichihara

Authors
  1. Naoki Kageyama
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Akio Kuwayama
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Tatsuo Takahashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Makoto Negoro
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kaoru Ichihara
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kageyama, N., Kuwayama, A., Takahashi, T. et al. Diagnosis, treatment and postoperative results of Cushing's disease. Neurosurg. Rev. 8, 177–183 (1985). https://doi.org/10.1007/BF01815442

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01815442

Keywords

Search

Navigation