{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,7]],"date-time":"2026-03-07T20:31:40Z","timestamp":1772915500301,"version":"3.50.1"},"reference-count":39,"publisher":"The Endocrine Society","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2002,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Total bilateral adrenalectomy remains the definitive procedure for cure in Cushing\u2019s disease. It is complicated by the development of Nelson\u2019s syndrome, the treatment of which remains troublesome. We report the long-term follow-up, median 17 yr (range, 8\u201322 yr), of 13 patients (3 males and 10 females) treated with pituitary surgery for Nelson\u2019s syndrome at a median age of 35 yr (range, 21\u201367 yr). The presence of a pituitary mass lesion necessitated neurosurgery in all. Preoperatively, the median plasma ACTH level was 664 pmol\/liter (range, 92\u20133665 pmol\/liter); this fell to 29 pmol\/liter (range, &amp;lt;2 to 1124 pmol\/liter) postoperatively (P &amp;lt; 0.0005). Cutaneous hyperpigmentation was reduced in all and resolved in 11 patients. The pituitary tumor bulk was clearly reduced in 12 patients. There was no perioperative mortality. No patient developed a visual field defect attributable to surgery. New anterior pituitary hormone deficiency occurred in seven patients, and permanent diabetes insipidus occurred in five patients. At latest follow-up, the median plasma ACTH is 73 pmol\/liter (range, &amp;lt;2 to 7759 pmol\/liter); six patients have levels of less than 44 pmol\/liter and also have a resolution of their pigmentation and no evidence of a recurrence of a pituitary mass lesion. We conclude that pituitary surgery is an efficacious treatment for mass lesions associated with Nelson\u2019s syndrome, has long-term benefit with minimal side effects, and must be considered in the management of this distressing complication.<\/jats:p>","DOI":"10.1210\/jc.2002-020299","type":"journal-article","created":{"date-parts":[[2002,12,5]],"date-time":"2002-12-05T03:42:14Z","timestamp":1039059734000},"page":"5465-5469","source":"Crossref","is-referenced-by-count":70,"title":["Neurosurgical Treatment of Nelson\u2019s Syndrome"],"prefix":"10.1210","volume":"87","author":[{"given":"P. A.","family":"Kelly","sequence":"first","affiliation":[{"name":"Departments of Endocrinology (P.A.K., A.B.G., G.M.B., P.J.J.), London EC 1A 7BE, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G.","family":"Samandouras","sequence":"additional","affiliation":[{"name":"Neurosurgery (G.S., F.A.), St. Bartholomew\u2019s and The Royal London Hospitals, London EC 1A 7BE, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A. B.","family":"Grossman","sequence":"additional","affiliation":[{"name":"Departments of Endocrinology (P.A.K., A.B.G., G.M.B., P.J.J.), London EC 1A 7BE, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F.","family":"Afshar","sequence":"additional","affiliation":[{"name":"Neurosurgery (G.S., F.A.), St. Bartholomew\u2019s and The Royal London Hospitals, London EC 1A 7BE, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G. M.","family":"Besser","sequence":"additional","affiliation":[{"name":"Departments of Endocrinology (P.A.K., A.B.G., G.M.B., P.J.J.), London EC 1A 7BE, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P. J.","family":"Jenkins","sequence":"additional","affiliation":[{"name":"Departments of Endocrinology (P.A.K., A.B.G., G.M.B., P.J.J.), London EC 1A 7BE, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"80","reference":[{"key":"2020071615005914900_R1","doi-asserted-by":"crossref","first-page":"445","DOI":"10.7326\/0003-4819-109-6-445","article-title":"Therapy of Cushing\u2019s disease: a consensus for pituitary microsurgery.","volume":"109","author":"Melby","year":"1988","journal-title":"Ann Intern Med"},{"key":"2020071615005914900_R2","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1111\/j.1365-2265.1991.tb00332.x","article-title":"The treatment of Cushing\u2019s syndrome.","volume":"34","author":"Atkinson","year":"1991","journal-title":"Clin Endocrinol (Oxf)"},{"key":"2020071615005914900_R3","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1111\/j.1365-2265.1993.tb00975.x","article-title":"Transsphenoidal resection in Cushing\u2019s disease: undetectable serum cortisol as the definition of successful treatment.","volume":"38","author":"Trainer","year":"1993","journal-title":"Clin Endocrinol (Oxf)"},{"key":"2020071615005914900_R4","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1056\/NEJM197107292850501","article-title":"Results of treatment in 108 patients with Cushing\u2019s syndrome.","volume":"285","author":"Orth","year":"1971","journal-title":"N Engl J Med"},{"key":"2020071615005914900_R5","first-page":"629","article-title":"Management of certain hyperfunctioning lesions of the adrenal cortex and medulla.","volume":"151","author":"Sprague","year":"1953","journal-title":"J Am Med Assoc"},{"key":"2020071615005914900_R6","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1056\/NEJM195807242590403","article-title":"ACTH-producing tumor of the pituitary gland.","volume":"259","author":"Nelson","year":"1958","journal-title":"New Engl J 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