Introduction Although there are now several new methods for the medical management of Cushing’s disease, for patients who have progressive severe signs and symptoms, surgery provides the best chance of a long lasting remission. Making the diagnosis of a pituitary tumor secreting excess levels of ACTH as the cause of Cushing’s disease can be complicated,… Continue Reading
Summary of The Endocrine Society Guideline on the Treatment of Cushing’s Syndrome: Part 1
Editor’s Note: Dr. Lynnette Nieman, NIH, NICHD, Bethesda, MD chaired the task force that developed the guideline. The task force also included Beverly M.K. Biller of Massachusetts General Hospital in Boston, MA; James W. Findling of the Medical College of Wisconsin in Milwaukee, WI; M. Hassan Murad of the Mayo Clinic in Rochester, MN; John… Continue Reading
Laparoscopic Adrenalectomy for Patients with Cushing’s Syndrome
Since its description in 1992, laparoscopic adrenalectomy has rapidly become the procedure of choice for unilateral adrenalectomy when the adrenal mass is less than 8 cm in size and there are no frank signs of malignancy (eg. invasion of contiguous structures). The postoperative recovery time and long-term morbidity associated with laparoscopic adrenalectomy are significantly reduced… Continue Reading
Patient Guide to Transsphenoidal Surgery for ACTH Secreting Pituitary Tumors
Question: What is Cushing’s syndrome? Cushing’s syndrome refers to the physical and emotional difficulties caused by an elevated cortisol level. Features of excess cortisol include weight gain, especially centrally, fatigue, easy bruisability, excess hair growth (termed hirsutism), susceptibility to infection, depression, menstrual irregularities in women, decreased libido and erectile dysfunction in men, high blood pressure,… Continue Reading
Answers From a Pituitary Surgeon
Question: Some Cushing’s patients have found that their insurance companies will not refer them to an “expert” pituitary surgeon. Why is an expert pituitary surgeon necessary? While there are no literature references that state exact percentages, the cure rate for pituitary tumors is directly related to the experience of the surgeon. Neurosurgery is a broad… Continue Reading
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