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CUSHING'S SYNDROME
Treatment Guideline Chart
Cushing’s syndrome is a condition which is due to prolonged exposure of the body tissue to excess cortisol (glucocorticoid hormone).
Laboratory tests and radiological findings confirm diagnosis and determine the actual cause of Cushing's syndrome.
Endogenous adrenocorticotropic hormone (ACTH)-independent Cushing's syndrome has adrenal hypersecretion due to adrenal adenoma, adrenal carcinoma, micronodular hyperplasia, and macronodular hyperplasia.
Exogenous ACTH-independent Cushing's syndrome has adrenal hypersecretion due to iatrogenic causes (eg drug-induced, corticosteroid use).

Radiotherapy

Pituitary Radiotherapy

  • 2nd-line therapy for Cushing’s disease (for patients not cured by transsphenoidal selective adenomectomy)
  • May be used as primary treatment in cases of unresectable or invasive tumors
  • Gamma knife is preferred
  • Effects: Remission in approximately >80% of patients 6-60 months after treatment
  • Complications: Hypopituitarism
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