Sunday, January 25, 2015

Bilateral adrenalectomy for Cushing's disease

I would love to see the whole article because the abstract seems pretty basic.  However, the news is good. Bilateral adrenalectomy or BLA is a good option for patients. Doctors should present this surgery as an option to all patients. It should be our choice to make.
Bilateral adrenalectomy for Cushing's disease.

Katznelson L1.
  • 1Departments of Medicine and Neurosurgery, Stanford University School of Medicine, 875 Blake Wilbur Dr MC 5826, Stanford, CA, 94305, USA,

Pituitary. 2015 Jan 8. [Epub ahead of print]

PURPOSE: Review the indications, outcomes, and consequences of bilateral adrenalectomy (BLA) in patients with Cushing's disease.
METHODS: A literature review was performed.
RESULTS: The primary therapy for Cushing's disease is surgery, with medical therapy and radiation therapy relegated to an adjuvant role. BLA is indicated in cases of persistent disease following pituitary surgery or in situations where rapid normalization of hypercortisolism is required. When performed via the laparoscopic approach, BLA is associated with a significantly reduced morbidity compared to the traditional, open approach. Following BLA, patients are at risk for adrenal crisis and the concern of Nelson's syndrome. However, BLA leads to a rapid resolution of the signs and symptoms of CS and leads to an improved long-term quality of life.
CONCLUSION: BLA should be considered in the treatment algorithm for patients with persistent CD after failed pituitary surgery, especially in patients who have severe consequences of hypercortisolism or desire pregnancy.

Friday, January 23, 2015

Seeing is Believing

7T MRI machines! A patient said the Cleveland Clinic got one in 2013. Wonder where else? These stronger magnet machines have existed for research but not clinical used. Finally, our community to get proper imaging for our disease. It's not our fault the pituitary gland is the size of a pea!