{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,7]],"date-time":"2026-03-07T20:32:26Z","timestamp":1772915546382,"version":"3.50.1"},"reference-count":23,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1983,8]]},"abstract":"<jats:p content-type=\"fine-print\">\u2713 The development of transsphenoidal microsurgery and the refinement of endocrinological and radiological diagnostic procedures have afforded therapeutic options appropriate to the individual case in patients with hypercortisolism. The present series of 100 cases is derived from 104 patients with the diagnosis of Cushing's disease who underwent transsphenoidal pituitary exploration between 1974 and 1981. Excluding four patients in whom the pituitary gland was not exposed because of intraoperative technical difficulties, an overall cure rate of 78% was achieved. Among 71 patients with tumors confined to the sella turcica, 87% had correction of their hypercortisolism, 11% represented therapeutic failures, and one patient had tumor recurrence. In contrast, among 25 patients with extrasellar extension, correction of hypercortisolism was achieved in only 48%, 40% failed to respond, and 12% of the patients had recurrence. Four patients who failed to respond to total hypophysectomy have ectopic sources of adenocorticotropic hormone.<\/jats:p>\n<jats:p content-type=\"fine-print\">The results indicate that transsphenoidal microsurgical exploration for a basophilic adenoma is the procedure of choice in adults and children with Cushing's disease. The diagnostic and surgical approach to these tumors, as well as pitfalls in the transsphenoidal treatment of Cushing's disease, are discussed.<\/jats:p>","DOI":"10.3171\/jns.1983.59.2.0195","type":"journal-article","created":{"date-parts":[[2009,5,8]],"date-time":"2009-05-08T16:17:02Z","timestamp":1241799422000},"page":"195-200","source":"Crossref","is-referenced-by-count":184,"title":["Transsphenoidal microsurgical management of Cushing's disease"],"prefix":"10.3171","volume":"59","author":[{"given":"James E.","family":"Boggan","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. Blake","family":"Tyrrell","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles B.","family":"Wilson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Medicine","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1097\/00005792-198101000-00003","article-title":"Cushing's syndrome: problems in diagnosis.","volume":"60","author":"Aron","year":"1981"},{"key":"b2","series-title":"J Clin Endocrinol Metab","doi-asserted-by":"publisher","first-page":"348","DOI":"10.1210\/jcem-50-2-348","article-title":"Cushing's disease: management by transsphenoidal pituitary microsurgery.","volume":"50","author":"Bigos","year":"1980"},{"key":"b3","series-title":"Q J Med","first-page":"693","article-title":"Cushing's disease: treatment by pituitary implantation of radioactive gold or yttrium seeds.","volume":"42","author":"Burke","year":"1973"},{"key":"b4","series-title":"Bull Johns Hopkins Hosp","first-page":"137","article-title":"The basophil adenomas of the pituitary body and their clinical manifestations (pituitary basophilism).","volume":"50","author":"Cushing","year":"1932"},{"key":"b5","series-title":"Ann Intern Med","doi-asserted-by":"publisher","first-page":"647","DOI":"10.7326\/0003-4819-94-5-647","article-title":"Selective venous sampling for ACTH in Cushing's syndrome. Differentiation between Cushing's disease and the ectopic ACTH syndrome.","volume":"94","author":"Findling","year":"1981"},{"key":"b6","series-title":"J Clin Endocrinol Metab","doi-asserted-by":"publisher","first-page":"413","DOI":"10.1210\/jcem-54-2-413","article-title":"Cushing's disease: transient secondary adrenal insufficiency after selective removal of pituitary microadenomas; evidence for a pituitary origin.","volume":"54","author":"Fitzgerald","year":"1982"},{"key":"b7","series-title":"Ann Intern Med","doi-asserted-by":"publisher","first-page":"829","DOI":"10.7326\/0003-4819-90-5-829","article-title":"The Cushing syndromes: changing views of diagnosis and treatment.","volume":"90","author":"Gold","year":"1979"},{"key":"b8","series-title":"Surg Neurol","doi-asserted-by":"publisher","first-page":"316","DOI":"10.1016\/0090-3019(81)90262-7","article-title":"Pituitary Cushing's syndrome and Nelson's syndrome: diagnostic criteria, surgical therapy, and results.","volume":"16","author":"Guthrie","year":"1981"},{"key":"b9","series-title":"Clin Neurosurg","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1093\/neurosurgery\/16.CN_suppl_1.185","article-title":"Transphenoidal microsurgery of the normal and pathological pituitary.","volume":"16","author":"Hardy","year":"1969"},{"key":"b10","series-title":"N Engl J Med","doi-asserted-by":"publisher","first-page":"957","DOI":"10.1056\/NEJM197711032971801","article-title":"Results of treating childhood Cushing's disease with pituitary irradiation.","volume":"297","author":"Jennings","year":"1977"},{"key":"b11","series-title":"JAMA","doi-asserted-by":"publisher","first-page":"2722","DOI":"10.1001\/jama.1981.03320230046024","article-title":"Cushing's disease in a patient with an ectopic pituitary adenoma.","volume":"246","author":"Kammer","year":"1981"},{"key":"b12","series-title":"J Clin Endocrinol Metab","doi-asserted-by":"publisher","first-page":"286","DOI":"10.1210\/jcem-54-2-286","article-title":"Adrenocorticotropin-secreting pituitary adenomas originate from the anterior or the intermediate lobe in Cushing's disease: differences in the regulation of hormone secretion.","volume":"54","author":"Lamberts","year":"1982"},{"key":"b13","series-title":"Management of Pituitary Adenomas and Related Lesions","first-page":"277","article-title":"The results of transsphenoidal surgery in specific clinical entities","author":"Laws","year":"1982"},{"key":"b14","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"699","DOI":"10.1227\/00006123-198106000-00011","article-title":"Development of pseudotumor cerebri after the removal of an adrenocorticotropic hormone-secreting pituitary adenoma: case report.","volume":"8","author":"Martin","year":"1981"},{"key":"b15","series-title":"Am J Med","doi-asserted-by":"publisher","first-page":"597","DOI":"10.1016\/0002-9343(52)90027-2","article-title":"The natural history of Cushing's syndrome.","volume":"13","author":"Plotz","year":"1952"},{"key":"b16","series-title":"Arch Pathol Lab Med","first-page":"448","article-title":"Pituitary adenomas in Cushing's disease. A histologic, ultrastructural, and immunochemical study.","volume":"102","author":"Robert","year":"1978"},{"key":"b17","series-title":"Mayo Clin Proc","first-page":"24","article-title":"Transsphenoidal removal of pituitary microadenoma in Cushing's disease.","volume":"53","author":"Salassa","year":"1978"},{"key":"b18","series-title":"Clinical Management of Pituitary Disorders","first-page":"287","article-title":"Conventional radiation therapy in the treatment of pituitary tumors","author":"Sheline","year":"1979"},{"key":"b19","series-title":"Clinical Management of Pituitary Disorders","first-page":"93","article-title":"Pathology of pituitary tumors and values of frozen section diagnosis","author":"Takei","year":"1979"},{"key":"b20","series-title":"AJR","doi-asserted-by":"publisher","first-page":"213","DOI":"10.2214\/ajr.137.2.213","article-title":"Sellar contour: anatomic-polytomographic correlation.","volume":"137","author":"Turski","year":"1981"},{"key":"b21","series-title":"N Engl J Med","doi-asserted-by":"publisher","first-page":"753","DOI":"10.1056\/NEJM197804062981401","article-title":"Cushing's disease. Selective trans-sphenoidal resection of pituitary microadenomas.","volume":"298","author":"Tyrrell","year":"1978"},{"key":"b22","series-title":"Hormone Secreting Pituitary Tumors","first-page":"199","article-title":"Cushing's disease: surgical management","author":"Wilson","year":"1982"},{"key":"b23","series-title":"Clinical Management of Pituitary Disorders","first-page":"229","article-title":"Neurosurgical aspects of Cushing's disease and Nelson's syndrome","author":"Wilson","year":"1979"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/59\/2\/article-p195.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/59\/2\/article-p195.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/59\/2\/article-p195.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,11,13]],"date-time":"2022-11-13T04:01:18Z","timestamp":1668312078000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/59\/2\/article-p195.xml"}},"subtitle":["Report of 100 cases"],"short-title":[],"issued":{"date-parts":[[1983,8]]},"references-count":23,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.3171\/jns.1983.59.2.0195","relation":{},"ISSN":["0022-3085"],"issn-type":[{"value":"0022-3085","type":"print"}],"subject":[],"published":{"date-parts":[[1983,8]]}}}