Surgical management of pediatric Cushing's disease: an analysis of 15 consecutive cases at a specialized neurosurgical center
Autor(a) principal: | |
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Data de Publicação: | 2010 |
Outros Autores: | , , , , |
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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Arquivos Brasileiros de Endocrinologia & Metabologia (Online) |
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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 & 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 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-27302010000100004 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1590/S0004-27302010000100004 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
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 & Metabologia v.54 n.1 2010 reponame:Arquivos Brasileiros de Endocrinologia & Metabologia (Online) instname:Sociedade Brasileira de Endocrinologia e Metabologia (SBEM) instacron:SBEM |
instname_str |
Sociedade Brasileira de Endocrinologia e Metabologia (SBEM) |
instacron_str |
SBEM |
institution |
SBEM |
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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1754734810897580032 |