{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T09:06:16Z","timestamp":1780131976262,"version":"3.54.0"},"reference-count":246,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FOC"],"published-print":{"date-parts":[[2007,9]]},"abstract":"<jats:p>\u2713Nelson syndrome (NS) is a rare clinical manifestation of an enlarging pituitary adenoma that can occur following bilateral adrenal gland removal performed for the treatment of Cushing disease. It is characterized by excess adreno-corticotropin secretion and hyperpigmentation of the skin and mucus membranes. The authors present a comprehensive review of the pathophysiology, diagnosis, and management of NS. Corticotroph adenomas in NS remain challenging tumors that can lead to significant rates of morbidity and mortality. A better understanding of the natural history of NS, advances in neurophysiology and neuroimaging, and growing experience with surgical intervention and radiation have expanded the repertoire of treatments. Currently available treatments include surgical, radiation, and medical therapy. Although the primary treatment for each tumor type may vary, it is important to consider all of the available options and select tthe one that is most appropriate for the individual case, particularly in cases of lesions resistant to intervention.<\/jats:p>","DOI":"10.3171\/foc.2007.23.3.15","type":"journal-article","created":{"date-parts":[[2008,1,24]],"date-time":"2008-01-24T07:25:20Z","timestamp":1201159520000},"page":"1-10","source":"Crossref","is-referenced-by-count":40,"title":["Nelson syndrome: comprehensive review of pathophysiology, diagnosis, and management"],"prefix":"10.3171","volume":"23","author":[{"given":"Magdalena J.","family":"Banasiak","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali R.","family":"Malek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-02300e13","series-title":"J Endocrinol Invest","doi-asserted-by":"publisher","first-page":"305","DOI":"10.1007\/BF03347595","article-title":"Effects of sodium-valproate administration on plasma ACTH levels in patients with ACTH hypersecretion","volume":"6","author":"Ambrosi","year":"1983"},{"key":"b2-02300e13","series-title":"Eur J Endocrinol","doi-asserted-by":"publisher","first-page":"503","DOI":"10.1530\/eje.1.01994","article-title":"Rosiglitazone for prevention or adjuvant treatment of Nelson's syndrome after bilateral adrenalectomy","volume":"153","author":"Andreassen","year":"2005"},{"key":"b3-02300e13","series-title":"Pituitary","doi-asserted-by":"publisher","first-page":"209","DOI":"10.1007\/s11102-005-1403-y","article-title":"The Nelson's syndrome \u2026 revisited","volume":"7","author":"Assi\u00e9","year":"2004"},{"key":"b4-02300e13","series-title":"J Clin Endocrinol Metab","doi-asserted-by":"publisher","first-page":"172","DOI":"10.1210\/jc.2006-1328","article-title":"Corticotroph tumor progression after adrenalectomy in Cushing's Disease: a reappraisal of Nelson's Syndrome","volume":"92","author":"Assi\u00e9","year":"2007"},{"key":"b5-02300e13","series-title":"J Clin Endocrinol Metab","doi-asserted-by":"publisher","first-page":"381","DOI":"10.1210\/jcem-49-3-381","article-title":"Adrenocorticotropin-dependent virilizing paraovarian tumors in Nelson's syndrome","volume":"49","author":"Baranetsky","year":"1979"},{"key":"b6-02300e13","series-title":"Clin Endocrinol (Oxf)","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1111\/j.1365-2265.1983.tb03215.x","article-title":"Comparison of preoperative and postoperative ACTH concentrations after bilateral adrenalectomy in Cushing's disease","volume":"18","author":"Barnett","year":"1983"},{"key":"b7-02300e13","series-title":"J Steroid Biochem Mol Biol","doi-asserted-by":"publisher","first-page":"379","DOI":"10.1016\/0960-0760(92)90072-Q","article-title":"Unrestrained production of proopiomelanocortin (POMC) and its peptide fragments by pituitary corticotroph adenomas in Cushing's disease","volume":"43","author":"Bertagna","year":"1992"},{"key":"b8-02300e13","series-title":"The Pituitary","first-page":"496","article-title":"Cushing's disease","author":"Bertagna","year":"2002"},{"key":"b9-02300e13","series-title":"Neurochirurgie","first-page":"173","article-title":"[Pituitary gland imaging in Cushing's disease.]","volume":"48","author":"Bonneville","year":"2002"},{"key":"b10-02300e13","series-title":"AJNR Am J Neuroradiol","first-page":"1183","article-title":"The accuracy of CT and MR evaluation of the sella turcica for detection of adreno-corticotropic hormone-secreting adenomas in Cushing disease","volume":"14","author":"Buchfelder","year":"1993"},{"key":"b11-02300e13","series-title":"J Clin Endocrinol Metab","doi-asserted-by":"publisher","first-page":"1513","DOI":"10.1210\/jcem.79.5.7962351","article-title":"p53 Protein accumulates in Cushings adenomas and invasive non-functional adenomas","volume":"79","author":"Buckley","year":"1994"},{"key":"b12-02300e13","series-title":"World J Surg","doi-asserted-by":"publisher","first-page":"775","DOI":"10.1007\/s002689900118","article-title":"Role and operative risk of bilateral adrenalectomy in hypercortisolism","volume":"20","author":"Chapuis","year":"1996"},{"key":"b13-02300e13","series-title":"Bull. 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