RT Journal
A1 Prinz RA, Brooks MH, Lawrence AM, Paloyan E
T1 THe continued importance of adrenalectomy in the treatment of cushing's disease
JF Archives of Surgery
JO Archives of Surgery
YR 1979
FD April 1
VO 114
IS 4
SP 481
OP 484
DO 10.1001/archsurg.1979.01370280135020
UL http://dx.doi.org/10.1001/archsurg.1979.01370280135020
AB • Eighteen patients with pituitary-dependent Cushing's disease have been treated during a ten-year period. Eleven of these received a total of 14 alternative forms of therapy in an attempt to control the clinical manifestations of Cushing's disease prior to adrenalectomy. However, no substantial improvement was noted in these patients, who included four receiving conventional pituitary irradiation, five receiving cyproheptadine, two receiving mitotane, and one each receiving metyrapone and phenytoin. One patient had an attempted transsphenoidal hypophysectomy that could not be accomplished because of hemorrhage. A complete remission of the signs, symptoms, and laboratory abnormalities of Cushing's disease occurred in all 18 patients following bilateral adrenalectomy. There was no operative mortality and morbidity was minimal. This experience confirms that bilateral adrenalectomy is a rapid, safe, and permanent means of reversing hypercortisolism and that it should remain an integral part of the treatment of Cushing's disease.(Arch Surg 114:481-484, 1979)