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Paper Information

Journal:   ARCHIVES OF IRANIAN MEDICINE   January 2004 , Volume 7 , Number 1; Page(s) 53 To 56.
 
Paper: 

CUSHINGS DISEASE, TRANSSPHENOIDAL SURGICAL RESULTS OF 11 CASES

 
 
Author(s):  MEHR AZIN M.*
 
* Tehran University of Medical Sciences, Tehran, Iran
 
Abstract: 
BACKGROUND-Cushings disease is the most common cause of endogenous Cushing Is syndrome (up to 60%) and is usually due to pituitary hyperplasia or basophilic adenoma.
MATERIALS AND METHODS-Eleven cases of Cushings disease that have been admitted to Shariati Hospital since June 1992 up to September 2000, had been reviewed These included three male, and eight female patients with an age range between (9 - 34) years with a mean of 21- 5 years The most common symptoms were headache, weight gain, and menstrual/libdo disturbances Obesity, moon face, hypertension, depression were the most common signs in our series. These patients were diagnosed on the basis of high serum and urinary free cortisol, abnormal 2-mg dexamethasone and normal 8-mg dexamethasone suppression test.
RESULTS-The neuroimaging investigation revealed normal sella turcica in 7 cases, double floor and enlarged sella turcica in 4. Computerized tomography was the most valuable tool which showed the adenoma in 9 cases, MRI with gadolinium injection were helpful in better delineation of the lesion in the last three cases. All patients were treated surgically via transsphenoidal approach. The mean duration of follow-up was S yrs (range, 0.5 - 8 yrs). There were regression of the clinical symptoms in 9 cases (82%q), and recurrence of these symptoms in one patient six month after the operation (9%). One patient died because of uncontrolled sepsis two months after operation (9%).
CONCLUSION-In conclusion the transsphenoidal approach is a safe and effective procedure for treatment of patients with diagnosis of Cushings disease of pituitary origin.
 
Keyword(s): CUSHINGS DISEASE; PITUITARY ADENOMA; TRANSSPHENOIDAL SURGERY.
 
References: 
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