Analysis and choice of treatment strategy for postoperative delayed remission in Cushing's disease
Feng Ming
Deng Kan
Bao Xinjie
Liu Xiaohai
Xing Bing
Lian Wei
Wei Junji
Zhang Xiaobo
Lu Lin
Zhu Huijuan
Yao Yong
Ma Wenbin
Wang Renzhi
Abstract：Objeetive To summar ize the cause,long-term therapeutic effect and treatment strategy of delayed remission after the operation via transsphenoidal approach for Cushing's disease.Methods Clinical date of 5 patients with Cushing's disease with delayed remission after transsphenoidal surgery were analyzed retrospectively,and the data were summarized such as age,gender,preoperative and postoperative pituitary hormone level,tumor size,pathology,time to remission and recurrence patterns.Results The average time of delayed remission was 41.4 d,ranged from 17 to 60 d after the operation in all the 5 patients.Recurrence occurred in 2 patients in 11 and 6 months respectively after the operation,and one received the second transsphenoidal surgery and achieved immediate remission,while the otherone was followed up continuously.24 h urinary free cortisol level was higher than normal value in 1 and 3 months after the operation in 1 patient,and recovered to normal 6 months after the operation.There were 2 patients without recurrence.Conclusions There may be delay remission in the patients who fail to immediate remission after the transsphenoidal surgery,so,immediate reoperation is not recommended.But the follow-up period should be extended,the cortisol level reexmanied,and monitor for tumor recurrence individualized treatment performed.
Keywords：pituitary neoplasmsCushing's diseasedelayed remission
Publication Date：2016-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：3( 389-391 )