[Corticotroph adenoma]

Presse Med. 2009 Jan;38(1):125-32. doi: 10.1016/j.lpm.2008.10.008. Epub 2008 Nov 28.
[Article in French]

Abstract

Corticotroph adenomas cause ACTH oversecretion responsible for Cushing's disease. This represents the most frequent cause of Cushing's syndrome, or chronic excess of endogenous glucocorticoids. Ninety percent of corticotroph adenomas are microadenomas, sometime not visible on MRI. Corticotroph macroadenomas are rare, but can be responsible for an aggressive tumor. Cushing's disease diagnosis requires careful hormonal and imaging investigations, aiming first at the diagnosis of Cushing's syndrome and in a second step at the diagnosis of its pituitary origin. The treatment of corticotroph adenoma is mainly based on pituitary surgery. In case of failure of pituitary surgery, or in patients in whom surgery is not appropriate as a first line treatment, medical therapy (mainly anticortisolic drugs), pituitary radiotherapy or surgical bilateral adrenalectomy can be discussed.

Publication types

  • English Abstract

MeSH terms

  • ACTH-Secreting Pituitary Adenoma / complications*
  • ACTH-Secreting Pituitary Adenoma / diagnosis
  • ACTH-Secreting Pituitary Adenoma / surgery
  • Adrenalectomy
  • Adrenocorticotropic Hormone / analysis
  • Chemotherapy, Adjuvant
  • Corticotropin-Releasing Hormone / analysis
  • Cushing Syndrome / diagnosis
  • Cushing Syndrome / etiology
  • Cushing Syndrome / therapy
  • Diagnosis, Differential
  • Humans
  • Hydrocortisone / analysis
  • Hydrocortisone / antagonists & inhibitors
  • Magnetic Resonance Imaging
  • Neoadjuvant Therapy
  • Pituitary ACTH Hypersecretion / diagnosis
  • Pituitary ACTH Hypersecretion / etiology*
  • Pituitary ACTH Hypersecretion / therapy
  • Pituitary Neoplasms / complications*
  • Pituitary Neoplasms / diagnosis
  • Pituitary Neoplasms / surgery
  • Radiotherapy, Adjuvant

Substances

  • Adrenocorticotropic Hormone
  • Corticotropin-Releasing Hormone
  • Hydrocortisone