Early repeat surgery for persistent Cushing’s disease: indication, approach and results

Abstract

Persistence of hypercortisolism after transsphenoidal surgery for Cushing’s disease may be caused by residual tumor tissue, primary removal of a non-ACTH secreting, coexisting adenoma, or negative pituitary exploration. Further treatment options include radio- or pharmacotherapy, adrenalectomy, and repeat pituitary surgery. We evaluated our long-term experience with early repeat surgery in Cushing’s disease which, if successful, is the treatment modality with the most rapid effect.