Data on 4 patients with Cushing's disease (2 microadenomas, 2 macroadenomas with chiasma syndromes) demonstrate that a few months after microsurgical extirpation of the pituitary adenoma (and, in macroadenomas, irradiation) the previously suppressed normal ACTH-producing cells recuperate and react adequately to stimulation. Because of the similar behaviour of the remainder of the gland, none of the 4 patients needed hormonal substitution and all were back at work full time about 1 year after the operation. This is in contrast to the obligatory need for corticoid substitution after bilateral epinephrectomy, and affords ground to consider pituitary microsurgery the treatment of choice in these patients.
Adenoma Adrenocorticotropic Hormone