CUSHINGS-DISEASE TREATED BY TOTAL ADRENALECTOMY - LONG-TERM OBSERVATIONS OF 43 PATIENTS

  • 1 January 1983
    • journal article
    • research article
    • Vol. 52  (206) , 224-231
Abstract
Forty-three patients were treated by total adrenalectomy for pituitary-dependent Cushing''s disease. The median period of observation was 10 yr (range 1-20 yr). Thirty-eight patients (88%) had rapid and lasting remissions. Of the 38 in remission, 21 became pigmented but without pituitary enlargement, 11 became pigmented with evidence of further pituitary expansion (Nelson''s syndrome) and 6 neither became pigmented nor showed pituitary expansion. Pituitary expansion was associated with high plasma ACTH values, and treatment of pituitary tumors by surgery or radiotherapy gave poor results. When compared with alternative methods of treatment, total adrenalectomy for Cushing''s disease is still satisfactory for many patients, despite advances in pituitary surgery, and has advantages over medical adrenalectomy with drugs.