[Criteria for the surgical treatment of hypothalamo-hypophyseal-dependent Cushing's syndrome].

This article offers criteria for the surgical treatment of pituitary-dependent Cushing's syndrome. Patients (n = 6) who showed no secondary complications of Cushing's disease underwent an implantation of 90Y and/or 192Ir into the pituitary gland. After implantation the excessive secretion of ACTH was suppressed to normal values and the symptoms of Cushing's syndrome disappeared. Following operation several patients received substitute therapy with other pituitary hormones. Fertility was not always conserved. Total adrenalectomy as alternative therapy was performed in adults with threatening symptoms of the disease (n = 4) and in children (n = 4). The symptoms of Cushing's syndrome disappeared. In two cases the development of a Nelson's tumor was observed. One was treated by implantation of 192Ir into the pituitary gland; the second needs no therapy up to now.