Endocrine Abstracts

Objective: ACTH-secreting pituitary tumors (ACTHomas) express vasopressin (AVP) receptors. AVP receptors are also present in other types of cancer, exerting different effects on tumor growth depending on the receptor subtype. AVP type 1 receptors (V1a and V1b) are associated with stimulation of cell proliferation, AVP receptor type 2 (V2r) is associated with antiproliferative effects. Desmopressin (DAVP) is a synthetic analog of AVP that acts as a selective agonist for V2r, which has shown antitumor properties in models of breast and colorectal cancer. In addition, DAVP stimulation the release of ACTH in ACTHomas. Remission of Cushing’s disease (CD) in the postoperative vary between 55-85%, recurrence of up to 25%. Objective: describe the influence of DAVP treatment in patients undergoing surgery for cushing’s disease (CD) who develop insipidus diabetes (ID).

Patients and methods: Retrospective analysis of patients who underwent as transsphenoidal surgery (TSS) for CD. Statistical analysis: t-student for comparison of means and Chi squared for comparison of proportions.

Results: 60 patients with CD treated with TSS. Age 41,72 ± 14,85 years. Women: 88.3%. Remission 75%. Postsurgical complications: 20% (3 meningitis, 9 transient DI). Of the patients in remission, 15.6% had transient ID. 26.7% had recurrence of CD. Of patients who presented transient ID: 28,57% had recurrence of CD vs 71,42% (P=0,901).

Conclusions: Transient ID is the most frequent complication in the postoperative period of CD. Patients with ID presented higher postsurgical ACTH and postsurgical basal cortisol levels without being statistically significant. CD recurrence does not differ from patients who did not present ID. Treatment with DAVP does not associated with increased risk of recurrence CD.