Endocrine Abstracts

Introduction: The treatment of choice in Cushing’s disease (CD) is transsphenoidal adenomectomy. However, the long term recurrence rate of the CD after transsphenoidal surgery in Turkish patients has not been determined so far.

Purpose: We aimed to determine the long term recurrence rates of CD in Turkish patients after transsphenoidal surgery.

Methods: The computer records of the 23 patients, operated for CD in our center during the interval 1999–2010, were retrospectively analysed.

Results: Nineteen (82%) of the patients were female and 4 (18%) were male [ranging in age between 20–62 years old, (41,7±11,2 years)]. Among the 23 patients, 14 (87%) had microadenoma, 2 (13%) had macroadenoma and 7 had normal pituitary MRI findings. Bilateral inferior petrosal sinus sampling (BIPSS) were performed in 9 (39%) patients. Four of the patients were operated for at least 2 times and 16 patients were operated on once. Two patients denied surgery. Two patients underwent gammaknife therapy (one as primary therapy). All of the patients were followed-up for 38,5±31,9 months (between 3–96 months) at 3–6 month intervals by basal cortisol, ACTH, urinary free cortisol levels and 1 mg dexamethasone supression test. Persistent cure was achieved in 11 patients (48%) at first surgery. Two (8,6%) patients had persistent disease after first surgery. Recurrence was determined in 8 (34,7%) patients after first surgery. Recurrence was determined after 9 months from surgery in one patient, between 12–24 months in 2, between 24–60 months in 3 and at 95th month in 2 patients, respectively.

Conclusion: All patients who undergo transsphenoidal surgery for CD should be followed properly for a long time, because recurrence could occur after a very long time period in patients who thought to be cured at first surgery.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector