The treatment of Cushing's syndrome was addressed recently by guidelines developed by the Endocrine Society. These indicate that the optimal treatment, when possible, is surgical resection of the causative tumor(s). When this is not possible, or the patient recurs, secondary treatment in Cushing's disease involves radiation therapy with adjunctive use of cortisol-lowering medications, or tumor-directed medical therapy such as cabergoline, or pasireotide or glucocorticoid receptor-directed treatment with mifepristone. Patients with ectopic ACTH secretion may have an occult or widely metastatic tumor, neither of which is amenable to surgical treatment. In this case, medical therapy with cortisol -lowering medications or mifepristone, or bilateral adrenalectomy, may be chosen. Treatments should be individualized to the circumstances, presentation, goals and values of each patient. Co-morbidities should be addressed in addition to primary tumor-directed therapy.
| Feelders, Richard A; Newell-Price, John; Pivonello, Rosario et al. (2018) Advances in the medical treatment of Cushing's syndrome. Lancet Diabetes Endocrinol : |
| Nieman, Lynnette Kaye (2018) Diagnosis of Cushing's Syndrome in the Modern Era. Endocrinol Metab Clin North Am 47:259-273 |
| Chatain, Grégoire P; Patronas, Nicholas; Smirniotopoulos, James G et al. (2018) Potential utility of FLAIR in MRI-negative Cushing's disease. J Neurosurg 129:620-628 |
| Ironside, Natasha; Chatain, Gregoire; Asuzu, David et al. (2018) Earlier post-operative hypocortisolemia may predict durable remission from Cushing's disease. Eur J Endocrinol 178:255-263 |
| Nieman, Lynnette K (2018) Recent Updates on the Diagnosis and Management of Cushing's Syndrome. Endocrinol Metab (Seoul) 33:139-146 |
| Asuzu, David; Chatain, Grégoire P; Hayes, Christina et al. (2017) Normalized Early Postoperative Cortisol and ACTH Values Predict Nonremission After Surgery for Cushing Disease. J Clin Endocrinol Metab 102:2179-2187 |
| Del Rivero, Jaydira; Kim, Chul; Eid, Mary et al. (2017) Thymic Hyperplasia after Treatment of ACTH-Dependent Cushing's Syndrome Can Be Mistaken for a Thymic Epithelial Tumor. J Thorac Oncol 12:e29-e32 |
| Lonser, Russell R; Nieman, Lynnette; Oldfield, Edward H (2016) Cushing's disease: pathobiology, diagnosis, and management. J Neurosurg :1-14 |
| Nieman, Lynnette K (2015) Update on subclinical Cushing's syndrome. Curr Opin Endocrinol Diabetes Obes 22:180-4 |
| Nieman, Lynnette K (2015) Cushing's syndrome: update on signs, symptoms and biochemical screening. Eur J Endocrinol 173:M33-8 |
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