Service des Maladies Endocriniennes et MétaboliquesCentre de Référence des Maladies Rares de la Surrénale, Hôpital Cochin, Faculté de Médecine Paris Descartes, Université Paris 5, Paris, France
Eur J Endocrinol. 2018 May;178(5):R183-R200. doi: 10.1530/EJE-18-0062. Epub 2018 Feb 21.
One of today's challenges in endocrinology is the treatment of Cushing's disease: Although pituitary surgery has the potential to 'cure' the patient and restore a completely normal pituitary adrenal axis, there are immediate failures and late recurrences that will ultimately require alternate therapeutic approaches. Their high number is in direct correlation with their serious limitations and they all appear to be 'default options'. This 'personal view' tries to shed some light on the inescapable difficulties of the current treatments of Cushing's disease and to provide some optimistic view for the future where the pituitary adenoma should be the 'reasonable obsession' of a successful therapeutist.
尽管垂体手术有潜力“治愈”患者并恢复完全正常的垂体-肾上腺轴,但会出现即刻失败和晚期复发,最终需要替代治疗方法。其高发生率与严重的局限性直接相关,而且它们似乎都是“默认选择”。这篇“个人观点”试图阐明当前库欣病治疗中不可避免的困难,并为未来提供一些乐观的看法,即垂体腺瘤应该成为成功治疗师的“合理关注焦点”。