Endonasal Removal of Microadenoma Associated with Cushing's Disease | VEOMED

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Endonasal Removal of Microadenoma Associated with Cushing's Disease
Daniel F. Kelly, MD
Brain Tumor Center, John Wayne Cancer Institute at Saint John's Health Center www.brain-tumor.org

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A 61 year old woman with 4-year history of progressive weight gain, fatigue, hypertension, osteoporosis

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Brief Description

Endonasal surgery for Cushing's disease

Full Description

A 61 year old woman with 4-year history of progressive weight gain, fatigue, hypertension, osteoporosis & depression. Hormonal evalution revealed elevated urinary free cortisol 180 (normal<50), midnight salivary cortisol 0.17 (normal<0.09) and serum ACTH of 40 (normal<27). Dynamic post-gadolinium MRI showed a probably inferior right-sided adenoma. An ACTH-secreting microadenoma was completely removed via an endonasal transsphenoidal approach. She remains in remission.

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References

Esposito F, Dusick JR, Cohan P, Moftakhar P, McArthur D, Wang C, Swerdloff RS, Kelly DF: Clinical review: Early morning cortisol levels as a predictor of remission after transsphenoidal surgery for Cushing's disease. J Clin Endocrinology Metabolism 91:7-13, 2006.

Kelly DF: Transsphenoidal surgery for Cushing’s disease: A review of: surgical success rates, predicting remission, managing failed surgery patients and Nelson’s Syndrome. Neurosurgical Focus 2007;23(3):E5.

Fatemi N, Dusick JR, de Paiva N, Kelly DF: The endonasal microscopic approach for pituitary adenomas and other parasellar tumors: a 10-year experience. Neurosurgery, 63 [ONS Suppl 2]; ONS 63:244-256, 2008

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Jul 15, 2009	862	VA:06:08:694:2009

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