TREATMENT OF CUSHINGS-DISEASE BY TRANS-SPHENOIDAL HYPOPHYSECTOMY

Abstract

Thirteen patients aged 24-65 with Cushing''s disease were treated by trans-sphenoidal hypophysectomy. There was 1 incident of meningitis and 1 late death from myocarditis. No radiotherapy was given. In 12 patients pituitary histology showed Crooke''s changes, and an adenoma was present in 7. On review of the 12 survivors 2-11 yr later, 11 are in complete remission. One patient still showed some clinical features of Cushing''s syndrome but steroid levels were normal. In 5 of the 7 premenopausal women, normal menstruation has returned and pregnancy has occurred in 3. In 4 patients replacement hormone therapy is no longer required, and a further 4 take only partial treatment. Trans-sphenoidal hypophysectomy is an effective treatment for Cushing''s disease.