Neurosurgical treatment of Cushing's disease in children and adolescents.

The authors report on 15 unselected consecutive children and adolescents treated for hypothalamo-pituitary Cushing's disease by transsphenoidal sella exploration and microadenomectomy. The diagnosis was established by dynamic endocrine testing. Peri- and post-operative measurements of ACTH levels were used to monitor the effectivity of the surgical procedure. In one patient no microadenoma was found. Hypercortisolism was corrected in 13 of the 15 patients. Although transient secondary adrenocortical insufficiency occurred in all of the successfully operated patients, no permanent damage of the anterior or posterior pituitary was found by postoperative endocrinological follow-up testing. One patient died of pneumonia as a direct consequence of surgery.