J Korean Med Sci.  2009 Feb;24(1):46-51. 10.3346/jkms.2009.24.1.46.

Comparisons between Macroadenomas and Microadenomas in Cushing's Disease: Characteristics of Hormone Secretion and Clinical Outcomes

• Hwang YC
• Chung JH
• Min YK
• Lee MS
• Lee MK
• Kim KW

• KMID: 1794405
• DOI: http://doi.org/10.3346/jkms.2009.24.1.46

Abstract

It has been suggested that the patients with Cushing's disease secondary to pituitary macroadenomas (>10 mm) have higher basal adrenocorticotropic hormone (ACTH) levels, which are less suppressible on high-dose dexamethasone suppression tests (HDDST). We compared the clinical and biochemical characteristics of patients with macroadenomas (N=7) and microadenomas (N=23) who were diagnosed at Samsung Medical Center in Korea between 1996 and 2006. Basal morning plasma ACTH levels were 101.5+/-23.2 pg/mL for macroadenoma patients and 83.6+/-11.1 pg/mL for microadenoma patients (mean+/-SEMs) (p=0.44). Morning serum cortisol levels were 26.8+/-3.2 microgram/dL for macroadenoma patients and 29.5 +/-2.9 microgram/dL for microadenoma patients (p=0.77). The proportion of patients who showed suppressibility on HDDST was almost identical in the two groups (71.4% [5/7] for macroadenoma patients vs. 72.7% [16/22] for microadenoma patients, p=1.00). Furthermore, the remission rate with trans-sphenoidal surgery was similar between the two groups (100% [5/5] for macroadenoma patients vs. 73.3% [11/ 15] for microadenoma patients, p=0.53). Thus, tumor size is not a major determinant of hormone secretion or clinical outcomes in patients with Cushing's disease.

Keyword

Pituitary ACTH Hypersecretion; Pituitary Adenoma; Outcome Assessment (Health Care)

MeSH Terms

Adenoma/complications/*metabolism/surgery
Adolescent
Adrenocorticotropic Hormone/blood/*secretion
Adult
Aged
Dexamethasone/metabolism
Female
Humans
Hydrocortisone/blood/*secretion
Male
Middle Aged
Pituitary ACTH Hypersecretion/*diagnosis/etiology
Pituitary Neoplasms/complications/*metabolism/surgery
Retrospective Studies

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