Endocrine Abstracts

Background: Cushing disease CD is a rare disorder, caused by an (ACTH) producing tumor. Transsphenoidal pituitary surgery (TSS) remains the treatment of choice for CD. Fewer information is available on the long-term outcome in the group of patients harboring ACTH-secreting adenoma. The aims of this study were to analyze our 20-year experience with surgical treatment in Cushing’s disease and to examine whether remission rate is related with size tumors.

Methods: Forty four consecutive patients with proven Cushing’s disease who under went to surgical treatment in our center between 1990 and 2010 were analyzed. The diagnosis was made using standard endocrinological criteria. Remission was defined with serum cortisol suppression on oral 1-mg dexamethasone overnight suppression test.

Results: Overall, 41/44 of the patients (80%) were female. The average age was 26.36±7.8. Average urinary cortisol was 566±462.42 μg/24 h and ACTH 61±74 pg/ ml. Microadenoma were present in 32 patients (72%) and macroadenoma in 12 (27%). Total remission was achieved in 34% of the subjects. (11 microadenomas and 3 macro adenomas). In the follow up of the remission patients there were a relapse in three patients. Mean follow up was 43.5±42.28 months in patients with out remission, and 67±59 months in patients with remission. The size of the tumor was not statistically different in the patients with remission (7.3±4.3 mm) compared to the patient with out remission (9.1±7.2 mm) (P=0.50).

Conclusion: The remission confirmed with serum cortisol suppression on oral 1- mg dexamethasone overnight suppression test do not depends on tumor size.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.