ECE2017 Eposter Presentations: Pituitary and Neuroendocrinology Neuroendocrinology (33 abstracts)
Bilateral inferior petrosal sinus sampling and the outcome of transsphenoidal surgery in patients with Cushing’s disease: experience of a Tertiary Portuguese Hospital
Ana Coelho Gomes 1 , Lia Lucas Neto 2 , Francisco Tortosa 3 , Maria Raquel Carvalho 1 , Eduardo Barreiros 1 , Luís Barreiros 1 , José Miguéns 4 & Maria João Bugalho 1
1Endocrinology, Diabetes and Metabolism Department, Santa Maria Hospital, Lisbon, Portugal; 2Neuroradiology Department, Santa Maria Hospital, Lisbon, Portugal; 3Pathology Department, Santa Maria Hospital, Lisbon, Portugal; 4Neurosurgery Department, Santa Maria Hospital, Lisbon, Portugal.
Introduction: Bilateral inferior petrosal sinus sampling (BIPSS) is the gold-standard for the differential diagnosis of ACTH-dependent Cushing Syndrome when the pituitary adenoma on MRI is doubtful or absent. This study aimed to analyze whether BIPSS can influence the outcome in patients with Cushing disease (CD).
Methods: Retrospective, descriptive study. Forty-two patients with CD submitted to transsphenoidal surgery (TS) between 2005 and 2016 were divided into two groups based on the performance of BIPSS. Different variables were analyzed: year of diagnosis, preoperative laboratory tests and pituitary MRI, immediate postoperative laboratory tests, histological findings, postoperative hypopituitarism, presence of permanent diabetes insipidus, follow-up duration and final outcome.
Results: Ten out of forty-two patients with CD were submitted to BIPSS.
Discussion: Groups were different in terms of the preoperative imaging. For the other variables, no differences were observed. The final outcome, despite the higher number of macroadenomas in the group without BIPSS was not statistically different. Results await further confirmation.
| BIPSS | No BIPSS | p-value | |
| Diagnosis Year (%): 1995–2000 / 2001–2010 / >2010 | 0/70/30 | 9/47/44 | 0.355 |
| Preoperative sellar MRI (%): Microadenoma / Macroadenoma / Indeterminate Lesion / No Image | 20/0/30/50 | 66/16/0/6 | <0.01 |
| Preoperative Laboratory Tests (%): Classical / Non-Classical | 100/0 | 59/13 | 0.159 |
| Immediate Postoperative Laboratory Tests (%): Criteria for Cure / No Criteria for Cure | 40/40 | 41/41 | 1 |
| Histology (%): Adenoma / Corticotroph Hyperplasia / Normal tissue | 60/10/30 | 78/3/9 | 0.462 |
| Postoperative anterior pituitary deficiency (%): Isolated / Multiple / None | 20/20/20 | 28/25/44 | 0.713 |
| Permanent Diabetes Insipidus (%): Yes / No | 0/100 | 6/94 | 0.418 |
| Mean Follow-Up (years) | 5.7±3.8 (0–11) | 6.8±5.1 (1–21) | 0.544 |
| Final Outcome (%): Remission / Active Disease | 70/30 | 47/50 | 0.386 |
| Note: In some parameters the sum of the partial percentages is not 100% because some patients didn’t have that information. | |||
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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