{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T13:54:04Z","timestamp":1756994044817,"version":"3.37.3"},"reference-count":36,"publisher":"Endocrinology Research Centre","issue":"3","license":[{"start":{"date-parts":[[2022,4,12]],"date-time":"2022-04-12T00:00:00Z","timestamp":1649721600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.probl-endojournals.ru\/jour\/about\/editorialPolicies#openAccessPolicy"}],"content-domain":{"domain":["www.probl-endojournals.ru"],"crossmark-restriction":true},"short-container-title":["Probl Endokrinol (Mosk)"],"abstract":"<jats:p>BACKGROUND: Cushing\u2019s disease (CD) is a rare disorder of a persistent cortisol excess caused by ACTH-secreting pituitary tumor (corticotropinoma). Transsphenoidal surgery (TSS) is a treatment of choice for \u0421D, which effectiveness range is from 70 to 90%. Recurrence rate after successful treatment is about 25%. If surgical treatment is unsuccessful or recurrence appear, radiation treatment is the next therapeutic option, which effectiveness range is also 90%, but the hypopituitarism rate as side effect of treatment is higher. Preoperative predictors of remission and recurrence are still unexplored what leads to further investigations.<\/jats:p><jats:p>AIM: Analysis of remission and recurrence rates of pediatric CD after successful treatment according to preoperative MRI and therapeutic option.<\/jats:p><jats:p>MATERIALS AND METHODS: We conducted a retrospective analysis of 90 pediatric patients with CD who were observed between 1992 and 2020 at the Endocrinology Research Centre.<\/jats:p><jats:p>RESULTS: The most common clinical symptoms of CD were weight gain [94%] and growth retardation [72%]. Pituitary tumor was detected on radiological imaging in 53\/90 patients [59%], there were no signs of visible adenoma in 37\/90 of patients\u00a0[41%]. 63 of 90 patients underwent TSS (70%), 27 patients underwent radiosurgery (30%). Remission rate after TSS was 71%\u00a0[45\/63], after radiosurgery \u2014 85% [23\/27]. There were no significant differences in remission rates after radical treatment according to preoperative MRI results (P=0.21 after TSS and P=0.87 after radiosurgery, \u04452 analysis). Recurrence after successful treatment was diagnosed in 10 patients. There were no significant differences in time to recurrence according to preoperative MRI results (P=0.055, \u04452 analysis). Time to recurrence was statistically different after TSS compared to radiosurgery (P=0.007, Kaplan\u2013Meier analysis) and in the group with developed adrenal insufficiency in the early postoperative period (P=0.04, Kaplan\u2013Meier analysis). Analysis of side effect of treatment showed that the frequency of growth hormone and gonadotrophin deficiency was statistically higher after radiosurgery (\u0440&lt;0.01, Kruskel\u2013Wallis ANOVA test). Diabetes insipidus was diagnosed only after TSS. CONCLUSION: Results of our study didn`t allow to use MRI-results as predictor of effectiveness treatment in pediatric CD. Therapeutic option has an impact on time to recurrence, not on recurrence rates. The frequency of growth hormone and gonadotrophin deficiency was statistically higher after radiosurgery compared to TSS. Further studies are needed to identify predictors of remission and recurrence in CD.&gt;&lt; 0.01, Kruskel\u2013Wallis ANOVA test). Diabetes insipidus was diagnosed only after TSS.<\/jats:p><jats:p>CONCLUSION: Results of our study didn`t allow to use MRI-results as predictor of effectiveness treatment in pediatric CD. Therapeutic option has an impact on time to recurrence, not on recurrence rates. The frequency of growth hormone and gonadotrophin deficiency was statistically higher after radiosurgery compared to TSS. Further studies are needed to identify predictors of remission and recurrence in CD.<\/jats:p>","DOI":"10.14341\/probl12854","type":"journal-article","created":{"date-parts":[[2022,7,16]],"date-time":"2022-07-16T06:38:39Z","timestamp":1657953519000},"page":"93-104","update-policy":"https:\/\/doi.org\/10.14341\/crossmarkpolicy2018","source":"Crossref","is-referenced-by-count":1,"title":["Course of Cushing`s disease and treatment outcomes in correlation with pituitary MRI in children"],"prefix":"10.14341","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8610-821X","authenticated-orcid":true,"given":"E. A.","family":"Yanar","sequence":"first","affiliation":[{"name":"Endocrinology Research Centre"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3832-6367","authenticated-orcid":true,"given":"N. V.","family":"Makazan","sequence":"additional","affiliation":[{"name":"Endocrinology Research Centre"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1320-6561","authenticated-orcid":true,"given":"M. A.","family":"Kareva","sequence":"additional","affiliation":[{"name":"Endocrinology Research Centre"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3074-6930","authenticated-orcid":true,"given":"A. V.","family":"Vorontsov","sequence":"additional","affiliation":[{"name":"Endocrinology Research Centre"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"V. P.","family":"Vladimirova","sequence":"additional","affiliation":[{"name":"Endocrinology Research Centre"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"O. B.","family":"Bezlepkina","sequence":"additional","affiliation":[{"name":"Endocrinology Research Centre"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5507-4627","authenticated-orcid":true,"given":"V. A.","family":"Peterkova","sequence":"additional","affiliation":[{"name":"Endocrinology Research Centre"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"5458","published-online":{"date-parts":[[2022,4,12]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","unstructured":"Sharma ST, Nieman LK, Feelders RA. Cushing\u2019s syndrome: epidemiology and developments in disease management. Clin Epidemiol. 2015;7:281-293. doi: https:\/\/doi.org\/10.2147\/CLEP.S44336","DOI":"10.2147\/CLEP.S44336"},{"key":"ref2","doi-asserted-by":"crossref","unstructured":"Stratakis CA. An update on Cushing syndrome in pediatrics. 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