Hostname: page-component-586b7cd67f-2brh9 Total loading time: 0 Render date: 2024-12-02T15:20:04.738Z Has data issue: false hasContentIssue false
  • English
  • Français

Cushing’s Disease: 50 Years Later

Published online by Cambridge University Press:  18 September 2015

Jules Hardy
Jules Hardy*
Affiliation:
Division of Neurosurgery, Faculty of Medicine, University of Montreal
*
1386 Sherbrooke E., Montreal, P.Q., Canada H2L 1M4
Rights & Permissions [Opens in a new window]

Summary:

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

The recent improvements in transsphenoidal microsurgery have once again placed the emphasis on the basophilic adenoma of the pituitary as the etiology of the disease originally described by Harvey Cushing fifty years ago.

In 75 operated cases, tumors were found in 60 cases: 52 were microadenomas, 4 were larger adenomas and 4 were invasive. In 15 cases, no tumor was found at surgery; a selective partial central hypophysectomy was performed in 11 cases and a total hypophysectomy in 4. Among the latter, 3 additional microadenomas were found at pathology. The majority of the microadenomas were located in the center of the gland most often near or within the neural lobe.

In 59 patients with a non invasive tumor, initial cure was obtained in 52 (88%); only 1 of the 4 patients with an invasive tumor was cured.

In the 12 cases without surgical or pathological tumor, partial or total hypophysectomy resulted in 10 cures (83%).

Type
Presidential Address: XVII Canadian Congress of Neurological Sciences
Information
Canadian Journal of Neurological Sciences , Volume 9 , Issue 4 , November 1982 , pp. 375 - 380
Copyright
Copyright © Canadian Neurological Sciences Federation 1982

References

Bigos, S.T., Robert, F., Pelletier, G., Hardy, J. (1977). Cure of Cushing’s Disease by Transsphenoidal Removal of a Microadenoma from a Pituitary Gland Despite a Radiographically Normal Sella Turcica. J. Clin. Endocrinol. Metab., 45, 1251–1260.CrossRefGoogle ScholarPubMed
Bigos, S.J., Somma, M., Rasio, E., Eastman, R.C., Lanthier, A., Johnston, H.H. and Hardy, J. (1980). Cushing’s Disease: Management by Transsphenoidal Pituitary Microsurgery. J. Clin. Endocrinol. Metab., 50, 348–354.CrossRefGoogle ScholarPubMed
Cushing, H. (1932). The Basophil Adenomas of the Pituitary Body and their Clinical Manifestations (pituitary basophilism). Bull. Johns Hopkins Hosp., 50, 137–195.Google Scholar
Gold, E. (1979). The Cushing Syndromes: Changing Views of Diagnosis and Treatment. Ann. Intern. Med., 90, 829–844.CrossRefGoogle ScholarPubMed
Hardy, J. (1969). Transsphenoidal Microsurgery of the Normal and Pathological Pituitary. Clin. Neurosurg., 16, 185–217.CrossRefGoogle Scholar
Hardy, J. (1971). Transsphenoidal Hypophysectomy. Neurosurgical Techniques. J. Neurosurg., 34, 581–594.Google ScholarPubMed
Hardy, J. (1973). Transsphenoidal Surgery of Hypersecreting Pituitary Tumors. In: Kohler, P.O. and Ross, G.T. (eds) Diagnosis and Treatment of Pituitary Tumors, New York, Elsevier, 179–194.Google Scholar
Hardy, J. (1975). Transsphenoidal Microsurgical Removal of Pituitary Microadenoma. Prog. Neurol. Surg., 6, 200–216.CrossRefGoogle Scholar
Hopwood, N., Kenny, F. (1975). Increased Incidence of Post-Adrenalectomy Nelson’s Syndrome in Pediatric vs Adult Cushing’s disease: A Nationwide Study (abstract). Pediatric Res., 9, 290.Google Scholar
Lamberts, S.W.J., De Lange, S.A. and Stefanko, S.Z. (1982). Adrenocorticotropin-Secreting Pituitary Adenomas Originate from the Anterior or the Intermediate Lobe in Cushing’s Disease: Differences in the Regulation of Hormone Secretion. J. Clin. Endocrinol. Metab., 54, 286–291.CrossRefGoogle ScholarPubMed
Melby, J.C. (1971). Therapeutic Possibilities in Cushing’s Syndrome (editorial). N. Engl. J. Med., 285, 288–289.CrossRefGoogle Scholar
Robert, F., Pelletier, G. and Hardy, J. (1978). Pituitary Adenomas in Cushing’s Disease. Arch. Pathol. Lab. Med., 102, 448–455.Google ScholarPubMed
Salassa, R.M., Kearns, T.P., Kernohan, J.W., Sprague, R.G., Maccarty, C.S. (1959). Pituitary Tumors in Patients with Cushing’s Syndrome. J. Clin. Endocrinol. Metab., 19, 1523–1539.CrossRefGoogle ScholarPubMed
Salassa, R.M., Laws, E.R. Jr, Carpenter, P.C. and Northcutt, R.C. (1978). Transsphenoidal Removal of Pituitary Microadenoma in Cushing’s Disease. Mayo Clin. Proa, 53, 24–28.Google ScholarPubMed
Tyrell, J.B., Brooks, R.M., Fitzgerald, P.A., Cofoid, P.B., Forsham, P.H. and Wilson, C.B. (1978). Cushing’s Disease: Selective Transsphenoidal Resection of Pituitary Microadenomas. N. Engl. J. Med., 298, 753–758.CrossRefGoogle Scholar