Pitfalls in the management of Cushing’s disease: A review

Abstract

The author presents a mature and comprehensive analysis of many aspects of the diagnosis and management of Cushing’s disease. Perhaps this is the most difficult of the pituitary tumors to deal with from a neurosurgical standpoint, and a review such as this one of the various pitfalls that may occur is extremely useful. The author has significant experience to draw from and makes a number of valuable recommendations. One important aspect of the management of patients who require radiation therapy or radiosurgery after failure of pituitary surgery to obtain a remission in Cushing’s disease is the use of ketoconazole to block cortisol synthesis, while waiting for the effects of the radiation to be manifest. This is an important part of the combined management of such patients and so long as they are