At our department of Endocrinology a 44-year-old patient with typical clinical signs of Cushings disease presented. Diagnostic procedure showed an ACTH-producing adenoma of the pituitary gland, so the patient underwent transsphenoidal surgery. Afterwards, hypercortisolism persisted and was treated with Ketoconazole. After a short period of time a pituitary hemorrhage occurred and resulted not only in a complete remission of Cushings symptoms, but also in hypopituitarism. One year later, the symptoms reoccured and MRI showed a regrowth of the pituitary adenoma. Surgery was repeated and this time histology showed a pituitary carcinoma. In the following years, therapy strategies included radiatio, adrenectomy and chemotherapy but these could not prevent the development of liver metastases and tumour progress, so the patient died 6 years after the onset of the disease.
03 - 07 May 2008
European Society of Endocrinology