Journal of Medicine and Life Science

Institute for Medical Science (제주대학교 의과학연구소)
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Treatment of Cushing's disease with macroadenoma through transsphenoidal surgery

나비굴경유 수술을 통해 완치된 뇌하수체 거대선종에 동반된 쿠싱병 1예

  • Lee, Sang Ah (Department of Endocrinology, Jeju National University School of Medicine) ;
  • Moon, Jae Cheol (Department of Endocrinology, Cheju Halla General Hospital)
  • 이상아 (제주대학교 의학전문대학원 내분비내과학교실) ;
  • 문재철 (제주한라병원 내분비내과)
  • Received : 2020.04.01
  • Accepted : 2020.11.02
  • Published : 2021.04.30
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Abstract

Cushing's disease (CD) is a rare illness characterized by chronic hypercortisolism secondary to the overproduction of adrenocorticotropic hormone by a pituitary adenoma, which is associated with a high risk of developing serious complications, such as diabetes mellitus, cardiovascular disease, and emotional disorders. Endoscopic transsphenoidal surgery is performed for the treatment of CD, and was initially preferred over other types of treatments. However, the recurrence after pituitary surgery for CD is a common problem after an initial successful surgery. In microadenomas, the remission rates were higher than those of macroadenoma. This patient had a giant tumor that was greater than 4 cm in length on sella magnetic resonance imaging, and panhypopituitarism was detected using a combined pituitary stimulation test. After transsphenoidal surgery, the patient required temporary hormone replacement for a short period of time. After 1 year, he showed a normal cortisol response on the overnight dexamethasone suppression test and low morning cortisol levels. Therefore, we indicated that the patient was cured of giant macroadenoma with panhypopituitarism before surgery, and thus, reported this case.

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References

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