• Journal of neurosurgery · Feb 2017

    Review

    Cushing's disease: pathobiology, diagnosis, and management.

    • Russell R Lonser, Lynnette Nieman, and Edward H Oldfield.
    • Department of Neurological Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio.
    • J. Neurosurg. 2017 Feb 1; 126 (2): 404-417.

    AbstractCushing's disease (CD) is the result of excess secretion of adrenocorticotropic hormone (ACTH) by a benign monoclonal pituitary adenoma. The excessive secretion of ACTH stimulates secretion of cortisol by the adrenal glands, resulting in supraphysiological levels of circulating cortisol. The pathophysiological levels of cortisol are associated with hypertension, diabetes, obesity, and early death. Successful resection of the CD-associated ACTH-secreting pituitary adenoma is the treatment of choice and results in immediate biochemical remission with preservation of pituitary function. Accurate and early identification of CD is critical for effective surgical management and optimal prognosis. The authors review the current pathophysiological principles, diagnostic methods, and management of CD.

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