ECE2015 Guided Posters Pituitary–Therapy of Cushing's disease (7 abstracts)
Neurosurgery outcome in patients with Cushing's disease with and without visualised pituitary adenoma on MRI, who underwent inferior petrosal sinus sampling
Zhanna Belaya , Patimat Khandaeva , Ludimila Rozhinskaya , Aleksandr Vorontsov , Ivan Sitkin , Andrey Grigoriev , Oksana Ivashenko , Larisa Dzeranova & Galina Melnichenko
Endocrinology Research Centre, Moscow, Russia.
Objective: To estimate the outcome of neurosurgery in patients with Cushing’s disease (CD) with and without pituitary adenoma visualisation on MRI.
Material and methods: Patients with confirmed CD (11.2008–11.2014) by both inferior petrosal sinus sampling (IPSS) and histological evaluation after neurosurgery were enrolled into the study. Subjects were referred for IPSS because of non-visualised pituitary adenoma or contradictory results of non-invasive tests. Remission of Cushing’s disease was confirmed in the event of development of adrenal insufficiency or normalisation of serum cortisol and 24 h urinary free cortisol (24hUFC) levels along with clinical remission at least during 3–6 months after neurosurgery. MRI was performed using Siemens Magnetom Harmony 1.0 T.
Results: A cohort of 113 (88 female) consecutive patients with CD confirmed by IPSS was enrolled, median of age (Q25–Q75) – 36 (27–50) years old; 24hUFC – 1903 (922–4219) nmol/24h; ACTH – 89.5 (60–135) pg/ml. In 51 cases pituitary adenoma was not visualised on MRI with gadolinium, 33 subjects were referred for IPSS because of adenoma ≤6 mm, 29 patients underwent IPSS due to negative for CD non-invasive tests. After the first neurosurgery remission was not achieved in 15 (29.4%) patients out of 51 without visualised adenoma on MRI; and in 9 (17.3%) cases out of 62 patients with visualised pituitary adenoma P=0.066 OR- 2.45 (0.97–6.21).
Conclusion: Remission rate after neurosurgery does not statistically significant differ between patients with CD with non-visualised pituitary adenoma on MRI and other patients with CD initially referred for IPSS.
Volume 37
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Endocrine Abstracts
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