Türk Nöroşirürji Dergisi 2025 , Vol 35 , Num 1
Nuances of the Endoscopic Approach in Pituitary Cushing"s Disease
Atakan EMENGEN1,Eren YILMAZ3,Aykut GÖKBEL1,Burak CABUK2,İhsan ANIK2,Savaş CEYLAN1
1Bahçeşehir Üniversitesi, Tıp Fakültesi, Beyin ve Sinir Cerrahisi Anabilim Dalı, İstanbul, Türkiye
2Kocaeli Üniversitesi, Tıp Fakültesi, Beyin ve Sinir Cerrahisi Anabilim Dalı, Kocaeli, Türkiye
3Cihanbeyli Devlet Hastanesi, Beyin ve Sinir Cerrahisi Kliniği, Konya, Türkiye
DOI : 10.5137/1019-5157.TND.3331 AIM: Cushing"s disease is a pathology characterized by endogenous hypercortisolism due to adrenocorticotropic hormone (ACTH) secreted from a pituitary adenoma. This study aimed to retrospectively review endoscopically performed ACTH adenoma surgery cases between 2001 and 2021.

MATERIAL and METHODS: A total of 344 patients were operated on for Cushing"s disease at the Pituitary Research Center. The data of these patients were analyzed retrospectively. Medical records, laboratory studies, radiological images, and surgery videos were analyzed. In some cases, recurrence rates and different pathological results were also noted.

RESULTS: The average age of the patients was 38 years (min 8, max 72). Preoperative MRIs revealed 210 microadenomas, 84 macroadenomas, and 50 patients with no lesions. Selective adenomectomy (preventive surgery) was performed in 194 of 344 patients. Exploratory surgery or partial hypophysectomy/hemihypophysectomy was performed in 150 patients.

CONCLUSION: The surgeon"s experience and the decision on the appropriate surgical strategy have an impact on the outcome in the treatment of Cushing"s disease. While various definitions have been made for the surgical treatment of Cushing"s disease such as pseudocapsular resection, selective adenomectomy, and hypophysectomy, different approaches must be developed due to the high recurrence rates. Anahtar Kelimeler : Cushing"s disease, Pituitary tumor, Endoscopic transsphenoidal surgery