Stereotactic radiosurgery for patients with ACTH-producing pituitary adenomas after prior adrenalectomy

Abstract

In this issue, Drs. Pollock and Young address the role of stereotactic radiotherapy in treating pituitary tumors associated with Nelson syndrome ( 1 Pollock B.E. Young Jr., W.F. Stereotactic radiosurgery for patients with ACTH-producing pituitary adenomas after prior adrenalectomy. Int J Radiat Oncol Biol Phys. 2002; 54: 841-843 Abstract Full Text Full Text PDF Scopus (53) Google Scholar ). Their retrospective clinical series examined the results of treating 11 patients who developed the syndrome after undergoing bilateral adrenalectomy to control the hypercortisolism of Cushing’s disease. They achieved arrest of tumor growth in 9 patients (82%), a better result than that seen with other approaches to this difficult clinical problem. In Nelson syndrome, the loss of negative feedback from adrenal to pituitary causes an enlarging, often aggressive, pituitary tumor, elevated fasting levels of plasma ACTH, and hyperpigmentation beyond that typically seen in patients with Cushing’s disease.