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Comparisons between Macroadenomas and Microadenomas in Cushing's Disease: Characteristics of Hormone Secretion and Clinical Outcomes

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...

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Detalles Bibliográficos
Autores principales: Hwang, You-Cheol, Chung, Jae Hoon, Min, Yong-Ki, Lee, Myung-Shik, Lee, Moon-Kyu, Kim, Kwang-Won
Formato: Texto
Lenguaje:English
Publicado: The Korean Academy of Medical Sciences 2009
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2650989/
https://www.ncbi.nlm.nih.gov/pubmed/19270812
http://dx.doi.org/10.3346/jkms.2009.24.1.46
Descripción
Sumario: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 µg/dL for macroadenoma patients and 29.5±2.9 µg/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.