Tratamiento de la enfermedad de Cushing. Cirugía transesfenoidal y radioterapia hipofisaria

Transsphenoidal surgery is currently considered the treatment of choice for Cushing's disease. Initial remission is achieved in approximately 70-85%, but 10-15% of patients with remission will suffer a recurrence months or years later. Pituitary irradiation has been used as a therapeutic tool f...

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Detalles Bibliográficos
Autores: Estrada García, Javier, Lamas Oliveira, Cristina
Tipo de recurso: artículo
Fecha de publicación:2009
País:España
Institución:Universidad de Castilla-La Mancha
Repositorio:RUIdeRA. Repositorio Institucional de la UCLM
OAI Identifier:oai:ruidera.uclm.es:10578/33328
Acceso en línea:https://hdl.handle.net/10578/33328
Access Level:acceso abierto
Palabra clave:Cirugía transesfenoidal
Cushing’s syndrome
Hipersecreción hipofisaria de ACTH
Pituitary ACTH hypersecretion
Pituitary irradiation
Radioterapia hipofisaria
Síndrome de Cushing
Transsphenoidal surgery
Descripción
Sumario:Transsphenoidal surgery is currently considered the treatment of choice for Cushing's disease. Initial remission is achieved in approximately 70-85%, but 10-15% of patients with remission will suffer a recurrence months or years later. Pituitary irradiation has been used as a therapeutic tool for many years. Nowadays, this option is considered a second-line treatment, to be used when there is postsurgical persistence or recurrence of the disease. The present article reviews the surgical approaches, remission rates reported by different groups, prognostic factors, and the most frequent complications after transsphenoidal surgery. We also review the different techniques that can be used for pituitary irradiation, as well as the efficacy and morbidity reported for each of these techniques in patients with Cushing's disease.