Cushing Disease: Medical and Surgical Considerations

Otolaryngol Clin North Am. 2022 Apr;55(2):315-329. doi: 10.1016/j.otc.2021.12.006. Epub 2022 Mar 4.


Cushing disease is a disorder of hypercortisolemia caused by hypersecretion of adrenocorticotropic hormone by a pituitary adenoma and is a rare diagnosis. Cushing disease presents with characteristic clinical signs and symptoms associated with excess cortisol, but diagnosis is difficult and often relies on repeated and varied endocrinologic assays and neuroradiologic investigations. Gold standard treatment is surgical resection of adrenocorticotropic hormone-secreting pituitary adenoma, which is curative. Patients require close endocrinologic follow-up for maintenance of associated neuroendocrine deficiencies and surveillance for potential recurrence. Medications, radiation therapy, and bilateral adrenalectomy are alternative treatments for residual or recurrent disease.

Keywords: Adenoma; Cushing disease; Endonasal; Endoscopic; Pituitary; Skull base; Transnasal.

Publication types

  • Review

MeSH terms

  • ACTH-Secreting Pituitary Adenoma* / complications
  • ACTH-Secreting Pituitary Adenoma* / diagnosis
  • ACTH-Secreting Pituitary Adenoma* / surgery
  • Adenoma* / surgery
  • Humans
  • Pituitary ACTH Hypersecretion* / complications
  • Pituitary ACTH Hypersecretion* / diagnosis
  • Pituitary ACTH Hypersecretion* / surgery
  • Pituitary Neoplasms* / complications
  • Pituitary Neoplasms* / surgery