21301487

Source:http://linkedlifedata.com/resource/pubmed/id/21301487

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Predicate	Object
rdf:type	pubmed:Citation
lifeskim:mentions	umls-concept:C0001554, umls-concept:C0221406, umls-concept:C1273870
pubmed:issue	5
pubmed:dateCreated	2011-4-19
pubmed:abstractText	Cushing disease is caused by a corticotroph tumor of the pituitary gland. Patients with Cushing disease are usually treated with transsphenoidal surgery, as this approach leads to remission in 70-90% of cases and is associated with low morbidity when performed by experienced pituitary gland surgeons. Nonetheless, among patients in postoperative remission, the risk of recurrence of Cushing disease could reach 20-25% at 10 years after surgery. Patients with persistent or recurrent Cushing disease might, therefore, benefit from a second pituitary operation (which leads to remission in 50-70% of cases), radiation therapy to the pituitary gland or bilateral adrenalectomy. Remission after radiation therapy occurs in ?85% of patients with Cushing disease after a considerable latency period. Interim medical therapy is generally advisable after patients receive radiation therapy because of the long latency period. Bilateral adrenalectomy might be considered in patients who do not improve following transsphenoidal surgery, particularly patients who are very ill and require rapid control of hypercortisolism, or those wishing to avoid the risk of hypopituitarism associated with radiation therapy. Adrenalectomized patients require lifelong adrenal hormone replacement and are at risk of Nelson syndrome. The development of medical therapies with improved efficacy might influence the management of this challenging condition.
pubmed:language	eng
pubmed:journal	http://linkedlifedata.com/resource/pubmed/journal/101500078
pubmed:citationSubset	IM
pubmed:status	MEDLINE
pubmed:month	May
pubmed:issn	1759-5037
pubmed:author	pubmed-author:BillerBeverly M KBM, pubmed-author:Medscape, pubmed-author:SwearingenBrookeB, pubmed-author:TritosNicholas ANA
pubmed:issnType	Electronic
pubmed:volume	7
pubmed:owner	NLM
pubmed:authorsComplete	Y
pubmed:pagination	279-89
pubmed:meshHeading	pubmed-meshheading:21301487-Adrenalectomy, pubmed-meshheading:21301487-Cushing Syndrome, pubmed-meshheading:21301487-Humans, pubmed-meshheading:21301487-Pituitary ACTH Hypersecretion
pubmed:year	2011
pubmed:articleTitle	Management of Cushing disease.
pubmed:affiliation	Neuroendocrine Unit, Zero Emerson Place, Suite 112, Massachusetts General Hospital, Boston, MA 02114, USA. ntritos@partners.org
pubmed:publicationType	Journal Article, Review