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Comparisons between macroadenomas and microadenomas in Cushing's disease: characteristics of hormone secretion and clinical outcomes.

Abstract
It has been suggested that the patients with Cushing's disease secondary to pituitary macroadenomas (>10 mm) have higher basal adrenocorticotropic hormone (ACTH) levels, which are less suppressible on high-dose dexamethasone suppression tests (HDDST). We compared the clinical and biochemical characteristics of patients with macroadenomas (N=7) and microadenomas (N=23) who were diagnosed at Samsung Medical Center in Korea between 1996 and 2006. Basal morning plasma ACTH levels were 101.5+/-23.2 pg/mL for macroadenoma patients and 83.6+/-11.1 pg/mL for microadenoma patients (mean+/-SEMs) (p=0.44). Morning serum cortisol levels were 26.8+/-3.2 microg/dL for macroadenoma patients and 29.5+/-2.9 microg/dL for microadenoma patients (p=0.77). The proportion of patients who showed suppressibility on HDDST was almost identical in the two groups (71.4% [5/7] for macroadenoma patients vs. 72.7% [16/22] for microadenoma patients, p=1.00). Furthermore, the remission rate with trans-sphenoidal surgery was similar between the two groups (100% [5/5] for macroadenoma patients vs. 73.3% [11/15] for microadenoma patients, p=0.53). Thus, tumor size is not a major determinant of hormone secretion or clinical outcomes in patients with Cushing's disease.
AuthorsYou-Cheol Hwang, Jae Hoon Chung, Yong-Ki Min, Myung-Shik Lee, Moon-Kyu Lee, Kwang-Won Kim
JournalJournal of Korean medical science (J Korean Med Sci) Vol. 24 Issue 1 Pg. 46-51 (Feb 2009) ISSN: 1598-6357 [Electronic] Korea (South)
PMID19270812 (Publication Type: Comparative Study, Journal Article)
Chemical References
  • Dexamethasone
  • Adrenocorticotropic Hormone
  • Hydrocortisone
Topics
  • Adenoma (complications, metabolism, surgery)
  • Adolescent
  • Adrenocorticotropic Hormone (blood, metabolism)
  • Adult
  • Aged
  • Dexamethasone (metabolism)
  • Female
  • Humans
  • Hydrocortisone (blood, metabolism)
  • Male
  • Middle Aged
  • Pituitary ACTH Hypersecretion (diagnosis, etiology)
  • Pituitary Neoplasms (complications, metabolism, surgery)
  • Retrospective Studies

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