The Nelson's Syndrome... Revisited

Overview

Journal Pituitary

Specialty Endocrinology

Date 2005 Sep 1

PMID 16132203

Citations 13

Authors

Guillaume Assie

Helene Bahurel

Jerome Bertherat

Michele Kujas

Paul Legmann

Xavier Bertagna

Affiliations

Soon will be listed here.

Abstract

Adrenalectomy is a radical therapeutic approach to control hypercortisolism in some patients with Cushing's disease. However it may be complicated by the Nelson's syndrome, defined by the association of a pituitary macroadenoma and high ACTH secretion after adrenalectomy. This definition has not changed since the end of the fifties. Today the Nelson's syndrome must be revisited with new to criteria using more sensitive diagnostic tools, especially the pituitary magnetic resonance imaging. In this paper we will review the pathophysiological aspects of corticotroph tumor growth, with reference to the impact of adrenalectomy. The main epidemiological data on the Nelson's syndrome will be presented. More importantly, we will propose a new pathophysiological and practical approach to this question which attempts to evaluate the Corticotroph Tumor Progression after adrenalectomy, rather than to diagnose the Nelson's syndrome. We will discuss the consequences for the management of Cushing's disease patients after adrenalectomy, and will also draw some perspectives.

Citing Articles

Prevalence of Nelson's syndrome after bilateral adrenalectomy in patients with cushing's disease: a systematic review and meta-analysis.

Papakokkinou E, Piasecka M, Carlsen H, Chantzichristos D, Olsson D, Dahlqvist P Pituitary. 2021; 24(5):797-809.

PMID: 34036460 PMC: 8416875. DOI: 10.1007/s11102-021-01158-z.

Recurrence after pituitary surgery in adult Cushing's disease: a systematic review on diagnosis and treatment.

Braun L, Rubinstein G, Zopp S, Vogel F, Schmid-Tannwald C, Pazos Escudero M Endocrine. 2020; 70(2):218-231.

PMID: 32743767 PMC: 7396205. DOI: 10.1007/s12020-020-02432-z.

Long-term outcome after bilateral adrenalectomy in Cushing's disease with focus on Nelson's syndrome.

Cohen A, Clifton Goldney D, Danilowicz K, Manavela M, Rossi M, Gomez R Arch Endocrinol Metab. 2019; 63(5):470-477.

PMID: 31271574 PMC: 10522264. DOI: 10.20945/2359-3997000000144.

Recent advances in understanding corticotroph pituitary tumor initiation and progression.

Renner U, Ciato D, Stalla G F1000Res. 2018; 7.

PMID: 30228864 PMC: 6117851. DOI: 10.12688/f1000research.14789.1.

A prospective longitudinal study of Pasireotide in Nelson's syndrome.

Daniel E, Debono M, Caunt S, Girio-Fragkoulakis C, Walters S, Akker S Pituitary. 2018; 21(3):247-255.

PMID: 29313180 PMC: 5942349. DOI: 10.1007/s11102-017-0853-3.

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