Cushing's disease treated by total adrenalectomy: long-term observations of 43 patients
Kelly, W.F.; MacFarlane, I.A.; Longson, D.; Davies, D.; Sutcliffe, H.
Quarterly Journal of Medicine 52(206): 224-231
1983
ISSN/ISBN: 0033-5622 PMID: 6310673 Document Number: 217452
Forty-three patients were treated by total adrenalectomy for pituitary-dependent Cushing's disease. The median period of observation was 10 years (range one to 20 years). Thirty-eight patients (88 per cent) had rapid and lasting remissions. Of the 38 in remission, 21 became pigmented but without pituitary enlargement, 11 became pigmented with evidence of further pituitary expansion (Nelson's syndrome) and six neither became pigmented nor showed pituitary expansion. Pituitary expansion was associated with high plasma ACTH values, and treatment of pituitary tumours by surgery or radiotherapy gave poor results. However, when compared with alternative methods of treatment, total adrenalectomy for Cushing's disease is still satisfactory for many patients, despite advances in pituitary surgery, and has advantages over 'medical adrenalectomy' with drugs.