Endocrine Abstracts

Nelson’s syndrome (NS) is a rare clinical syndrome of an enlarging, aggresive corticotroph pituitary adenoma that can occur following bilateral adrenalectomy performed in the treatment of CD.

The aim of this work is the evaluation of the early and long-term results of the microsurgery in a single surgeon’s series of patients with NS

During the period from January 2000 to December 2005 - ten patients with NS have been operated on. The authors analyzed surgical outcome in the NS group of 7 women and 3 men with the mean age of 47.99 years (range 39–66, S.D.±8.47 years). NS was diagnosed on the clinical signs and symptoms, especially hiperpigmentation of the skin, elevated serum ACTH level and progression of the pituitary tumor. Parasellar extension of the adenomas was measured according Knosp’s scale and Hardy–Wilson’s scale in both groups. Pituitary function and radiological examinations were evaluated in the early postoperative time, 30 days after operation and in the follow-up. Histological examination was based on the WHO (2004) criteria.

According to the criteria of the remission of the Nelson’s syndrome, 5 patients (50%) were cured.

No perioperative mortality was reported. The three patients presented pituitary insufficiency and two patients - diabetes insipidus. There were no cerebrospinal fluid leakage after surgery. The pituitary carcinoma was recognized in one case.

Transsphenoidal microsurgical removal of pituitary adenomas is safe and effective treatment of Nelson’ syndrome.