Recurrence of Cushing's disease in childhood after radiotherapy-induced remission

Journal Article · Wed Jul 01 04:00:00 EDT 1987 · Am. J. Dis. Child.; (United States)

DOI:https://doi.org/10.1001/archpedi.1987.04460070038018· OSTI ID:6275663

Cappa, M; Stoner, E; DiMartino-Nardi, J; Pang, S; Temeck, J; New, M I

A 16-year-old female patient with recurrent Cushing's disease (CD) underwent successful treatment with pituitary irradiation. Within one year after radiotherapy, cortisol levels had returned to normal (but with continued absence of diurnal variation), growth velocity improved, and puberty ensued. Five years after treatment, the patient developed clinical and biochemical evidence of recurrent CD. The high baseline evening corticotropin level (9 pmol/L (40 pg/mL)) was unresponsive (maximum level, 10 pmol/L (46 pg/mL)) to stimulation with ovine corticotropin-releasing hormone (CRF). In patients with CD treated with radiotherapy, the corticotropin response to CRF stimulation may not be reliably compared with that of normal control values. After pituitary adenomectomy, the corticotropin concentration was still unresponsive to CRF. We suggest that the pituitary tumor was secondary to abnormal hypothalamic CRF regulation not corrected by pituitary irradiation; therefore, CD may recur despite pituitary irradiation.

• Research Organization: New York Hospital-Cornell Medical Center, New York
• OSTI ID: 6275663
• Journal Information: Am. J. Dis. Child.; (United States), Journal Name: Am. J. Dis. Child.; (United States) Vol. 7; ISSN AJDCA
• Country of Publication: United States
• Language: English

Related Subjects

550603* -- Medicine-- External Radiation in Therapy-- (1980-)
62 RADIOLOGY AND NUCLEAR MEDICINE
ADOLESCENTS
ADRENAL HORMONES
AGE GROUPS
BODY
CORTICOSTEROIDS
CORTICOSTERONE
DISEASES
ENDOCRINE GLANDS
GLANDS
GLUCOCORTICOIDS
HORMONES
HYDROXY COMPOUNDS
KETONES
MEDICINE
NEOPLASMS
NUCLEAR MEDICINE
ORGANIC COMPOUNDS
ORGANS
PATIENTS
PITUITARY GLAND
POST-IRRADIATION EXAMINATION
PREGNANES
RADIOLOGY
RADIOTHERAPY
SECRETION
STEROID HORMONES
STEROIDS
THERAPY