뇌하수체 미세선종에 의한 쿠싱병의 접형골경유 수술의 치료성적

• Published in: The Korean journal of medicine Vol. 53; no. 6; pp. 811 - 816
• Main Authors: 이윤용, Yun Yong Lee, 김진성, Jin Seong Kim, 문병술, Byeong Sul Mun, 신찬수, Chan Soo Shin, 김성연, Seong Yeon Kim, 조보연, Bo Youn Cho, 이홍규, Hong Kyu Lee, 고창순, Chang Soon Koh, 정희원, Hee Won Joeng, 한대희, Dae Hee Han, 한문희, Moom Hee Han, 장기현, Kee Hyun Chang
• Format: Journal Article
• Language: Korean
• Published: 대한내과학회 01.12.1997
• Subjects: Cushing`s disease; Pituitary microadenoma; Transsphenoidal microsurgery
• ISSN: 1738-9364

Background: Cushing's disease is a hypercortisolic state attributable to hypersecretion of ACTH at pituitary gland Most of these diseases are due to pituitary microadenoma. Selective removal of adenoma by transsphenoidal microsurgery is the treatment of choice for Cushing's disease. We evaluated 25 cases to analyze results of transsphenoidal microsurgery and to identify prognostic factors that may predict successful outcome. Methods: From 1989 to 1995, 25 patients were diagnosed as having Cushing's disease in Seoul National University Hospital. They were underwent pituitary microsurgery and confirmed to have pituitary microadenoma radiologically and pathologically. About these patients. retrospective evaluation was done. Results: The patients consist of 21 females and 4 males and the age was ranged from 23 to 49 years. 19 patients (76%) were judged as immediate remission. The preoperative clinical, hormonal, and radiological characteristics of the remission and failure groups were similiar The patients who were immediate remission were followed from 3 months to 72 months. 3 patients had recurrences(15.8%) at 4, 8, 49 months after operation. The pre and postoperative clinical, hormonal, and radiological characteristics of the long-term remission and recurrence groups were similiar. We could not find any predictable factors of surgical outcome. Conclusion: The first line trearment of Cushing's disease is transsphenoidal microsurgery. However considering relative late and high rate of recurrence of Cushing's disease following curative surgery, careful longterm follow up is mandatory.