Dilemmas in the Management of Pituitary Tumors-Dilemmas in the Management of Pituitary Tumors

Video Transcription

Video Summary

Summary:<br /><br />The first summary discusses Nelson syndrome, a complication that occurs in patients with Cushing's disease after bilateral adrenalectomy. Diagnosis is based on criteria such as corticotroph tumor growth, increased plasma ACTH levels, and the development of skin pigmentation. Management options include pediatric surgery, radiotherapy, active surveillance, and medical therapy. A retrospective cohort study showed the best tumor progression-free survival rate with pediatric surgery. Radiotherapy and surgery with adjuvant radiotherapy also had good outcomes. No specific medical therapy has been established. The management of Nelson syndrome is challenging, and further research is needed.<br /><br />The second summary focuses on the use of radiotherapy as a second-line treatment for Cushing's syndrome after pituitary surgery or in cases of relapse. Radiotherapy has success rates ranging from 50% to 80% in achieving remission but can lead to hypopituitarism as a side effect. Individualized management and follow-up are important, including monitoring HPA axis activity, treating pituitary deficiencies, managing comorbidities, and monitoring for potential side effects. Two case examples illustrate the challenges in managing patients after radiotherapy. Further research is needed to develop evidence-based management pathways for Cushing's syndrome after radiotherapy.<br /><br />No credits were mentioned in the provided summary description.

Keywords

Nelson syndrome

Cushing's disease

bilateral adrenalectomy

corticotroph tumor growth

plasma ACTH levels

skin pigmentation

pediatric surgery

radiotherapy

tumor progression-free survival

adjuvant radiotherapy

hypopituitarism

HPA axis activity

evidence-based management pathways


EndoCareers \| Contact Us \| Privacy Policy \| Terms of Use	CONNECT WITH US
© 2021 Copyright Endocrine Society. All rights reserved.	2055 L Street NW, Suite 600 \| Washington, DC 20036 202.971.3636 \| 888.363.6274