Outcome of Transphenoid Surgery for Corticotroph Pituitary Tumors

Background & Importance: The aim of this study was to demonstrate the result of transsphenoid microsurgery for Cushing disease in ourcenter and comparing the results in details with other articles, to achieve the best decision for patients management in future.Case Presentation: Between 1991 to 2015, 50 patients suffering from Cushing disease were operated. Before operation, endocrine testsand neuroimaging examinations were done for all patients and all of them were operated via transsphenoid approach. They were followedup in clinic with endocrine tests and imaging in regular intervals. During this study, 50 Cushing cases including 47 primary and threesecondary tumors were operated. Thirty four (68%) tumors were microadenoma and 16 (32%) macroadenoma. A patient died due to postoperativefulminant meningitis (mortality=2%). Mean of follow-up was five years. Overall, 40 (80%) patients had remission after operationand 9 (18%) patients achieved no remission, three of them had macroadenoma and six microadenoma. During follow-up period, three (6%)patients had recurrence which needed second operation. In secondary tumor and in macroadenoma with cavernous sinus involvement, theresult was not good (33% and 0% remission, respectively).Conclusion: Transsphenoid surgery is a safe and effective first choice method to manage Cushing disease compared to other treatmentmodalities. In recurrent or resistant cases, other modalities could help to manage patients.

کلیدواژه ها:

Cushing Disease ، Microadenoma ، Cavernous Sinus ، Transsphenoid Surgery