Thursday, December 20, 2012

Uncured Cushies and Extra-Pituitary Tumors

extra-

1. a prefix meaning "outside," "beyond," freely used as an English formative: extrajudicial; extraterritorial; extra-atmospheric.

As I reflect on Lori's Cushing's segment today on the Dr Oz show, I remember that her fourth pituitary surgery revealed a tumor in her sinus and her fifth surgery removed her entire pituitary gland as well as part of the bone.

Internet surfing led me to stumble upon this 1999 article. For the first time, I see an official, medical journal article about uncured Cushies, multiple surgeries, and finally finding unsuspecting culprits in non-pituitary places. Extra pituitary tumors sounds like extra terrestrials, though not as innocent as the E.T. portrayed in the movie. While I have seen more cases of suspected extra-pituitary tumors mentioned on the online groups for Cushing's patients, this decade-old article shows that we are not off-base in our assumptions. 

Regardless, this article is fascinating. i hope you enjoy it the way I did. It gives me concrete hope as I face uncertainty waiting for a tumor to show up eventually on a pituitary MRI. I have considered an exploratory third pituitary surgery. This article and Lori's segment today reminds me to take note of all signs I see around me, keep fighting for my life, and continue claw and my way forward to my cure from
Cushing's.

- Melissa 


Extrapituitary Parasellar Microadenoma in Cushing's


Conclusion

Negative sellar exploration, despite the results of endocrine evaluation indicating Cushing's disease, the high incidence of failure of total hypophysectomy, and remission of Cushing's syndrome after sellar irradiation, suggest that the etiology of refractory Cushing's disease in many patients lies near the sella but is not in the pituitary gland. In such patients, the diagnostic and surgical effort should consider the identification and selective resection of an extrapituitary parasellar adenoma and the avoidance of total hypophysectomy and adrenalectomy, which necessitate life-long hormonal replacement therapy and risk development of Nelson's syndrome (2127).