Application of different variants of endoscopic transphenoidal removal of corticotropinomas in order to increase the frequency and duration of remission

Abstract

Itsenko-Cushing’s disease is a severe neuroendocrine disease caused by chronic hyperproduction of adrenocorticotropic hormone by a corticotrophic pituitary tumor (corticotropinoma). Surgical tumor resection remains the gold standard in the treatment of Itsenko-Cushing’s disease and leads to remission in 65–95 % of cases. Despite the benign nature of the disease, even in specialized neurosurgical centers, the recurrence rate of the disease is 25–35 % of cases. This paper presents an analysis of the effectiveness of various options for endoscopic transnasal removal of corticotropinomas, the selection of which was based on the topographic and anatomical features of the tumors. It was found that each of the surgical treatment options provides comparable results in achieving remission (from 81,3 to 87,9 %), while the most optimal method of surgical treatment in terms of recurrence-free survival and postoperative endocrine disorders is partial hypophysectomy, which will increase the likelihood of long-term remission of the disease.