caa a22 4500 469049464 CHVBK 20180323132826.0 cr unu---uuuuu 170328e19921201xx s 000 0 eng 10.1007/BF02921364 doi (NATIONALLICENCE)springer-10.1007/BF02921364 Failure of total hypophysectomy to remove intrasellar microadenoma in cushing's disease [Elektronische Daten] [J. Verhelst, R. Klaes, G. Smets, G. Klöppel, A. Hoorens, R. Abs, C. Mahler] The pathological findings are described of a female patient with persistent Cushing's disease after two unsuccessful transsphenoidal operations: a left transsphenoidal hemihypophysectomy followed by a total hypophysectomy 1 month later. The patient was finally cured by bilateral adrenalectomy but suddenly died of heart failure 4 months later. Postmortem examination did not show invasive ACTH-secreting tissue in the pituitary region or an ectopic ACTH-secreting tumor, as initially presumed. Instead, a very small corticotroph adenoma was located immediately under the diaphragm sellae at the left side. The reasons for surgical failure in Cushing's disease are discussed. As in our patient, a missed small intrasellar adenoma must not be excluded when "total” hypophysectomy fails to cure Cushing's disease. Humana Press Inc., 1992 Verhelst J. Department of Endocrinology, A.Z. Middelheim, Lindendreef 1, B-2020, Antwerp, Belgium aut Klaes R. Department of Neurosurgery, A.Z. Middelheim, Antwerp aut Smets G. Department of Pathology, Academic Hospital Jette, Free University of Brussels, Belgium aut Klöppel G. Department of Pathology, Academic Hospital Jette, Free University of Brussels, Belgium aut Hoorens A. Department of Pathology, Academic Hospital Jette, Free University of Brussels, Belgium aut Abs R. Department of Endocrinology, University Hospital Antwerp, Belgium aut Mahler C. Department of Endocrinology, A.Z. Middelheim, Lindendreef 1, B-2020, Antwerp, Belgium aut Endocrine Pathology Humana Press 3/4(1992-12-01), 205-208 1046-3976 3:4<205 1992 3 12022 https://doi.org/10.1007/BF02921364 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/BF02921364 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Verhelst J. Department of Endocrinology, A.Z. Middelheim, Lindendreef 1, B-2020, Antwerp, Belgium aut NATIONALLICENCE 700 1- Klaes R. Department of Neurosurgery, A.Z. Middelheim, Antwerp aut NATIONALLICENCE 700 1- Smets G. Department of Pathology, Academic Hospital Jette, Free University of Brussels, Belgium aut NATIONALLICENCE 700 1- Klöppel G. Department of Pathology, Academic Hospital Jette, Free University of Brussels, Belgium aut NATIONALLICENCE 700 1- Hoorens A. Department of Pathology, Academic Hospital Jette, Free University of Brussels, Belgium aut NATIONALLICENCE 700 1- Abs R. Department of Endocrinology, University Hospital Antwerp, Belgium aut NATIONALLICENCE 700 1- Mahler C. Department of Endocrinology, A.Z. Middelheim, Lindendreef 1, B-2020, Antwerp, Belgium aut NATIONALLICENCE 773 0- Endocrine Pathology Humana Press 3/4(1992-12-01), 205-208 1046-3976 3:4<205 1992 3 12022 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer