The Treatment of Cushing's Disease by Trans-sphenoidal Hypophysectomy

Thirteen patients aged 24 to 65 with Cushing's disease havebeen treated by tranfssphenoidal hypophysectomy. There was oneincident of meningitis and one late death from myocarditis.No radiotherapy was given. In 12 patients pituitary histologyshowed Crooke's changes and an adenoma was present in seven.On review of the 12 survivors two to 11 years later, 11 arein complete remission. One patient still showed some clinicalfeatures of Cushing's syndrome but steroid levels were normal.In five of the seven premenopausal women normal menstruationhas returned and pregnancy has occurred in three. In four patientsreplacement hormone therapy is no longer required and a furtherfour take only partial treatment. We conclude that transsphenoidalhypophysectomy is an effective treatment for Cushing's disease.