Neurochirurgia degli adenomi ipofisari ACTH secernenti

Surgical treatment is the first-line treatment of Cushing’s disease (CD). Remission of disease is the principal aim of surgery. When this is not possible, maximal reduction of tumour size and cortisol levels are important objectives of surgical therapy. Surgery is performed through the transsphenoidal route in almost all cases. Patients with Cushing’s disease often have a very small lesion, thus a thorough sellar exploration is required to detect the pathological tissues. Surgical treatment of pituitary adenomas implies a minor risk of complications, even though some of them may be life threatening. Several factors may affect the remission rates, but the experience of the neurosurgeon is of paramount importance.