Surgical management of pediatric Cushing's disease: an analysis of 15 consecutive cases at a specialized neurosurgical center

Detalhes bibliográficos
Autor(a) principal: Oliveira,Ricardo Santos de
Data de Publicação: 2010
Outros Autores: Castro,Margaret de, Antonini,Sonir Roberto Rauber, Martinelli Júnior,Carlos Eduardo, Moreira,Ayrton Custódio, Machado,Helio Rubens
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Arquivos Brasileiros de Endocrinologia & Metabologia (Online)
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-27302010000100004
Resumo: OBJECTIVE: The aim of this study was to review the results of surgery for pediatric patients with Cushing's disease who were less than 18 years old and underwent transsphenoidal surgery in a specialized center during a 25-year period. SUBJECTS AND METHODS: Retrospective study, in which the medical records, histology and pituitary imaging of 15 consecutive pediatric patients with Cushing's disease (mean age: 13 years) were evaluated by the same team of endocrinologists and a neurosurgeon from 1982 to 2006. Patients were considered cured when there was clinical adrenal insufficiency and serum cortisol levels were below 1. 8 µg/dL or 50 nmol/L after one, two, three, or seven days following surgery; they therefore required cortisone replacement therapy. Follow-up was for a median time of 11.5 years (range: 2 to 25 years). RESULTS: Clinical and biochemical cure was achieved in 9/15 patients (60%) exclusively after transsphenoidal surgery. Hypopituitarism was observed in four patients; growth hormone deficiency, in two; permanent diabetes insipidus, in one case. CONCLUSIONS: Cushing's disease is rare in children and adolescents. Transsphenoidal surgery is an effective and safe treatment in most of these patients. Plasma cortisol level < 1. 8 µg/dL following surgery is the treatment goal and is a good predictive factor for long-term cure of Cushing's disease.
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spelling Surgical management of pediatric Cushing's disease: an analysis of 15 consecutive cases at a specialized neurosurgical centerCushing's diseasepituitary tumortranssphenoidal surgerypediatric neurosurgeryOBJECTIVE: The aim of this study was to review the results of surgery for pediatric patients with Cushing's disease who were less than 18 years old and underwent transsphenoidal surgery in a specialized center during a 25-year period. SUBJECTS AND METHODS: Retrospective study, in which the medical records, histology and pituitary imaging of 15 consecutive pediatric patients with Cushing's disease (mean age: 13 years) were evaluated by the same team of endocrinologists and a neurosurgeon from 1982 to 2006. Patients were considered cured when there was clinical adrenal insufficiency and serum cortisol levels were below 1. 8 µg/dL or 50 nmol/L after one, two, three, or seven days following surgery; they therefore required cortisone replacement therapy. Follow-up was for a median time of 11.5 years (range: 2 to 25 years). RESULTS: Clinical and biochemical cure was achieved in 9/15 patients (60%) exclusively after transsphenoidal surgery. Hypopituitarism was observed in four patients; growth hormone deficiency, in two; permanent diabetes insipidus, in one case. CONCLUSIONS: Cushing's disease is rare in children and adolescents. Transsphenoidal surgery is an effective and safe treatment in most of these patients. Plasma cortisol level < 1. 8 µg/dL following surgery is the treatment goal and is a good predictive factor for long-term cure of Cushing's disease.Sociedade Brasileira de Endocrinologia e Metabologia2010-02-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-27302010000100004Arquivos Brasileiros de Endocrinologia &amp; Metabologia v.54 n.1 2010reponame:Arquivos Brasileiros de Endocrinologia & Metabologia (Online)instname:Sociedade Brasileira de Endocrinologia e Metabologia (SBEM)instacron:SBEM10.1590/S0004-27302010000100004info:eu-repo/semantics/openAccessOliveira,Ricardo Santos deCastro,Margaret deAntonini,Sonir Roberto RauberMartinelli Júnior,Carlos EduardoMoreira,Ayrton CustódioMachado,Helio Rubenseng2010-04-07T00:00:00Zoai:scielo:S0004-27302010000100004Revistahttps://www.aem-sbem.com/ONGhttps://old.scielo.br/oai/scielo-oai.php||abem-editoria@endocrino.org.br1677-94870004-2730opendoar:2010-04-07T00:00Arquivos Brasileiros de Endocrinologia & Metabologia (Online) - Sociedade Brasileira de Endocrinologia e Metabologia (SBEM)false
dc.title.none.fl_str_mv Surgical management of pediatric Cushing's disease: an analysis of 15 consecutive cases at a specialized neurosurgical center
title Surgical management of pediatric Cushing's disease: an analysis of 15 consecutive cases at a specialized neurosurgical center
spellingShingle Surgical management of pediatric Cushing's disease: an analysis of 15 consecutive cases at a specialized neurosurgical center
Oliveira,Ricardo Santos de
Cushing's disease
pituitary tumor
transsphenoidal surgery
pediatric neurosurgery
title_short Surgical management of pediatric Cushing's disease: an analysis of 15 consecutive cases at a specialized neurosurgical center
title_full Surgical management of pediatric Cushing's disease: an analysis of 15 consecutive cases at a specialized neurosurgical center
title_fullStr Surgical management of pediatric Cushing's disease: an analysis of 15 consecutive cases at a specialized neurosurgical center
title_full_unstemmed Surgical management of pediatric Cushing's disease: an analysis of 15 consecutive cases at a specialized neurosurgical center
title_sort Surgical management of pediatric Cushing's disease: an analysis of 15 consecutive cases at a specialized neurosurgical center
author Oliveira,Ricardo Santos de
author_facet Oliveira,Ricardo Santos de
Castro,Margaret de
Antonini,Sonir Roberto Rauber
Martinelli Júnior,Carlos Eduardo
Moreira,Ayrton Custódio
Machado,Helio Rubens
author_role author
author2 Castro,Margaret de
Antonini,Sonir Roberto Rauber
Martinelli Júnior,Carlos Eduardo
Moreira,Ayrton Custódio
Machado,Helio Rubens
author2_role author
author
author
author
author
dc.contributor.author.fl_str_mv Oliveira,Ricardo Santos de
Castro,Margaret de
Antonini,Sonir Roberto Rauber
Martinelli Júnior,Carlos Eduardo
Moreira,Ayrton Custódio
Machado,Helio Rubens
dc.subject.por.fl_str_mv Cushing's disease
pituitary tumor
transsphenoidal surgery
pediatric neurosurgery
topic Cushing's disease
pituitary tumor
transsphenoidal surgery
pediatric neurosurgery
description OBJECTIVE: The aim of this study was to review the results of surgery for pediatric patients with Cushing's disease who were less than 18 years old and underwent transsphenoidal surgery in a specialized center during a 25-year period. SUBJECTS AND METHODS: Retrospective study, in which the medical records, histology and pituitary imaging of 15 consecutive pediatric patients with Cushing's disease (mean age: 13 years) were evaluated by the same team of endocrinologists and a neurosurgeon from 1982 to 2006. Patients were considered cured when there was clinical adrenal insufficiency and serum cortisol levels were below 1. 8 µg/dL or 50 nmol/L after one, two, three, or seven days following surgery; they therefore required cortisone replacement therapy. Follow-up was for a median time of 11.5 years (range: 2 to 25 years). RESULTS: Clinical and biochemical cure was achieved in 9/15 patients (60%) exclusively after transsphenoidal surgery. Hypopituitarism was observed in four patients; growth hormone deficiency, in two; permanent diabetes insipidus, in one case. CONCLUSIONS: Cushing's disease is rare in children and adolescents. Transsphenoidal surgery is an effective and safe treatment in most of these patients. Plasma cortisol level < 1. 8 µg/dL following surgery is the treatment goal and is a good predictive factor for long-term cure of Cushing's disease.
publishDate 2010
dc.date.none.fl_str_mv 2010-02-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-27302010000100004
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dc.language.iso.fl_str_mv eng
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dc.relation.none.fl_str_mv 10.1590/S0004-27302010000100004
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dc.publisher.none.fl_str_mv Sociedade Brasileira de Endocrinologia e Metabologia
publisher.none.fl_str_mv Sociedade Brasileira de Endocrinologia e Metabologia
dc.source.none.fl_str_mv Arquivos Brasileiros de Endocrinologia &amp; Metabologia v.54 n.1 2010
reponame:Arquivos Brasileiros de Endocrinologia & Metabologia (Online)
instname:Sociedade Brasileira de Endocrinologia e Metabologia (SBEM)
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reponame_str Arquivos Brasileiros de Endocrinologia & Metabologia (Online)
collection Arquivos Brasileiros de Endocrinologia & Metabologia (Online)
repository.name.fl_str_mv Arquivos Brasileiros de Endocrinologia & Metabologia (Online) - Sociedade Brasileira de Endocrinologia e Metabologia (SBEM)
repository.mail.fl_str_mv ||abem-editoria@endocrino.org.br
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