Update on the management of recurrent Cushing's disease

Martin J. Rutkowski, Patrick M. Flanigan, Manish K. Aghi

Research output: Contribution to journalArticlepeer-review

21 Scopus citations


After transsphenoidal surgery, Cushing's disease (CD) shows excellent long-term remission rates, but it may recur and pose a therapeutic challenge. Findings in recent published reports on the treatment of recurrent adrenocorticotropic hormone (ACTH)-secreting tumors suggest that repeat resection, radiation-based therapies such as Gamma Knife surgery and proton-beam radiosurgery, pharmacotherapy, and bilateral adrenalectomy all have important roles in the treatment of recurrent CD. Each of these interventions has inherent risks and benefits that should be presented to the patient during counseling on retreatment options. Radiation-based therapies increasingly appear to have efficacies similar to those of repeat resection in achieving biochemical remission and tumor control. In addition, an expanding retinue of medication-based therapies, several of which are currently being evaluated in clinical trials, has shown some promise as tertiary adjunctive therapies. Lastly, bilateral adrenalectomy may offer durable control of refractory recurrent CD. An increasing number of published studies with long-term patient outcomes highlight the evolving treatment patterns in the management of recurrent CD.

Original languageEnglish (US)
Article numberE16
JournalNeurosurgical focus
Issue number2
StatePublished - 2015
Externally publishedYes


  • Adenoma
  • Adrenalectomy
  • Adrenocorticotropic hormone
  • Cushing's disease
  • Radiation
  • Radiosurgery
  • Recurrent
  • Surgery

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology


Dive into the research topics of 'Update on the management of recurrent Cushing's disease'. Together they form a unique fingerprint.

Cite this