{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,7]],"date-time":"2026-03-07T20:31:44Z","timestamp":1772915504129,"version":"3.50.1"},"reference-count":21,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1987,2]]},"abstract":"<jats:p content-type=\"fine-print\">\u2713 The endocrinological, radiological, surgical, and pathological experience with 34 consecutive patients operated on for Cushing's disease is presented. Preoperative endocrine evaluation demonstrated that 19 patients had \u201ctypical\u201d endocrine patterns for pituitary adrenocorticotropic hormone (ACTH)-dependent hypercortisolism and 11 had \u201catypical\u201d testing. Pituitary pathology was found in 95% of the patients with typical preoperative endocrine testing but in only 55% of those with atypical testing. Eight of 34 preoperative computerized tomography scans demonstrated tumors, which correlated in all instances with the surgical findings. Microadenomas were removed from 25 patients, 22 of whom achieved postoperative remission of endocrine symptoms. Macroadenomas were found in three patients, only one of whom achieved remission after surgery. One patient had removal of an adenoma in the pharyngeal pituitary, and in another an ectopic lung carcinoid was excised; both of these patients were in postoperative remission. Four patients underwent transsphenoidal exploration but no definitive explanation was found for their hypercortisolism; these patients were not in remission. Immunohistochemical staining was performed on every specimen and all tumors showed excessive ACTH-secreting cells. A new rapid stain of the fibrovascular stroma is described.<\/jats:p>","DOI":"10.3171\/jns.1987.66.2.0204","type":"journal-article","created":{"date-parts":[[2009,5,8]],"date-time":"2009-05-08T16:22:37Z","timestamp":1241799757000},"page":"204-212","source":"Crossref","is-referenced-by-count":101,"title":["Surgical treatment of Cushing's disease"],"prefix":"10.3171","volume":"66","author":[{"given":"William F.","family":"Chandler","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David E.","family":"Schteingart","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ricardo V.","family":"Lloyd","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul E.","family":"McKeever","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gloria","family":"Ibarra-Perez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"195","DOI":"10.3171\/jns.1983.59.2.0195","article-title":"Transsphenoidal microsurgical management of Cushing's disease. Report of 100 cases.","volume":"59","author":"Boggan","year":"1983"},{"key":"b2","series-title":"Endocrine Surgery Update.","first-page":"163","article-title":"Pituitary surgery for endocrine disorders","author":"Chandler","year":"1983"},{"key":"b3","series-title":"Clin Neurosurg","first-page":"553","article-title":"Controversies in the management of Cushing's disease.","volume":"33","author":"Chandler","year":"1986"},{"key":"b4","series-title":"Standard Methods of Clinical Chemistry.","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1016\/B978-1-4831-9683-1.50014-9","volume":"2","author":"Chaney","year":"1958"},{"key":"b5","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":"b6","series-title":"Steroids","doi-asserted-by":"publisher","first-page":"647","DOI":"10.1016\/0039-128X(75)90057-4","article-title":"A specific, non-chromatographic radioimmunoassay for human plasma cortisol.","volume":"26","author":"Dash","year":"1975"},{"key":"b7","series-title":"Endocrinology.","first-page":"103","article-title":"Anatomy and cytology of the normal and abnormal pituitary gland","volume":"1","author":"Ezrin","year":"1979"},{"key":"b8","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":"b9","series-title":"Can J Neurol Sci","doi-asserted-by":"publisher","first-page":"375","DOI":"10.1017\/S0317167100044279","article-title":"Cushing's disease: 50 years later.","volume":"9","author":"Hardy","year":"1982"},{"key":"b10","series-title":"Contemp Neurosurg","first-page":"1","article-title":"Current management of Cushing's disease. Part I.","volume":"7","author":"Kuwayama","year":"1985"},{"key":"b11","series-title":"Contemp Neurosurg","first-page":"1","article-title":"Current management of Cushing's disease. Part II.","volume":"7","author":"Kuwayama","year":"1985"},{"key":"b12","series-title":"J Clin Endocrinol Metab","doi-asserted-by":"publisher","first-page":"793","DOI":"10.1210\/jcem-50-4-793","article-title":"Failure of clinical remission after transsphenoidal removal of a microadenoma in a patient with Cushing's disease: multiple hyperplastic and adenomatous cell nests in surrounding pituitary tissue.","volume":"50","author":"Lamberts","year":"1980"},{"key":"b13","series-title":"Am J Surg Pathol","doi-asserted-by":"publisher","first-page":"251","DOI":"10.1097\/00000478-198304000-00004","article-title":"Prolactin and growth hormone-producing pituitary adenomas. An immunohistochemical and ultrastructural study.","volume":"7","author":"Lloyd","year":"1983"},{"key":"b14","series-title":"J Neuropathol Exp Neurol","doi-asserted-by":"publisher","first-page":"490","DOI":"10.1097\/00005072-198209000-00002","article-title":"Refractory Cushing's disease caused by multinodular ACTH-cell hyperplasia.","volume":"41","author":"McKeever","year":"1982"},{"key":"b15","series-title":"Arch Pathol Lab Med","first-page":"509","article-title":"Stromal and nuclear markers for the rapid identification of pituitary adenomas at biopsy.","volume":"109","author":"McKeever","year":"1985"},{"key":"b16","series-title":"N Engl J Med","doi-asserted-by":"publisher","first-page":"100","DOI":"10.1056\/NEJM198501103120207","article-title":"Preoperative lateralization of ACTH-secreting pituitary microadenomas by bilateral and simultaneous inferior petrosal venous sinus sampling.","volume":"312","author":"Oldfield","year":"1985"},{"key":"b17","series-title":"Trans Am Clin Climato Assoc","first-page":"122","article-title":"Cushing's disease \u2014 50 years later.","volume":"94","author":"Salassa","year":"1982"},{"key":"b18","series-title":"Metabolism","first-page":"484","article-title":"A comparison of the characteristics of increased adrenocortical function in obesity and in Cushing's syndrome.","volume":"12","author":"Schteingart","year":"1963"},{"key":"b19","series-title":"J Biol Chem","doi-asserted-by":"publisher","first-page":"923","DOI":"10.1016\/S0021-9258(18)65419-5","article-title":"The determination of 17,21-dihydroxy-20-ketosteroids in urine and plasma.","volume":"210","author":"Silber","year":"1954"},{"key":"b20","series-title":"N Engl J Med","doi-asserted-by":"publisher","first-page":"889","DOI":"10.1056\/NEJM198404053101405","article-title":"Treatment of Cushing's disease in childhood and adolescence by transsphenoidal microadenomectomy.","volume":"310","author":"Styne","year":"1984"},{"key":"b21","series-title":"Eur J Clin Biol Res","first-page":"485","article-title":"Le dosage radioimmunologique de l'ACTH plastmatique: resultats chez les sujects normaux.","volume":"16","author":"Vague","year":"1971"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/66\/2\/article-p204.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/66\/2\/article-p204.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/66\/2\/article-p204.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,7,24]],"date-time":"2022-07-24T16:50:08Z","timestamp":1658681408000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/66\/2\/article-p204.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1987,2]]},"references-count":21,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.3171\/jns.1987.66.2.0204","relation":{},"ISSN":["0022-3085"],"issn-type":[{"value":"0022-3085","type":"print"}],"subject":[],"published":{"date-parts":[[1987,2]]}}}