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The role of inferior petrosal sinus sampling in the diagnostic localization of Cushing's disease.

Publication ,  Journal Article
Lad, SP; Patil, CG; Laws, ER; Katznelson, L
Published in: Neurosurg Focus
2007

Cushing's syndrome can present a complex problem of differential diagnosis. Of cases in which hypercortisolemia results from an adrenocorticotropic hormone (ACTH)-dependent process, approximately 80% are due to a pituitary adenoma (Cushing's disease [CD]), 10% are due to adrenal lesions, and the remaining 10% are secondary to ectopic ACTH secretion. For patients with CD, surgical removal of the pituitary adenoma is the treatment of choice. Thus, localization of the source of ACTH secretion is critical in guiding timely treatment decisions. Inferior petrosal sinus sampling (IPSS) is considered to be the gold standard for confirming the origin of ACTH secretion in patients with Cushing's syndrome. The authors present an overview of IPSS--both the technique and its interpretation--as well as a summary of recent studies. A number of other techniques are discussed including sampling from the cavernous sinus, the jugular vein, and multiple sites to aid the diagnosis and lateralization of ACTH-producing pituitary adenomas. Management is best undertaken by a comprehensive multidisciplinary team taking into account the results of all the biochemical and imaging studies available, to provide the best advice in patient treatment decisions.

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Published In

Neurosurg Focus

DOI

EISSN

1092-0684

Publication Date

2007

Volume

23

Issue

3

Start / End Page

E2

Location

United States

Related Subject Headings

  • Predictive Value of Tests
  • Pituitary ACTH Hypersecretion
  • Petrosal Sinus Sampling
  • Neurology & Neurosurgery
  • Humans
  • Adrenocorticotropic Hormone
  • 3209 Neurosciences
  • 1109 Neurosciences
  • 1103 Clinical Sciences
 

Citation

APA
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MLA
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Lad, S. P., Patil, C. G., Laws, E. R., & Katznelson, L. (2007). The role of inferior petrosal sinus sampling in the diagnostic localization of Cushing's disease. Neurosurg Focus, 23(3), E2. https://doi.org/10.3171/foc.2007.23.3.3
Lad, Shivanand P., Chirag G. Patil, Edward R. Laws, and Laurence Katznelson. “The role of inferior petrosal sinus sampling in the diagnostic localization of Cushing's disease.Neurosurg Focus 23, no. 3 (2007): E2. https://doi.org/10.3171/foc.2007.23.3.3.
Lad SP, Patil CG, Laws ER, Katznelson L. The role of inferior petrosal sinus sampling in the diagnostic localization of Cushing's disease. Neurosurg Focus. 2007;23(3):E2.
Lad, Shivanand P., et al. “The role of inferior petrosal sinus sampling in the diagnostic localization of Cushing's disease.Neurosurg Focus, vol. 23, no. 3, 2007, p. E2. Pubmed, doi:10.3171/foc.2007.23.3.3.
Lad SP, Patil CG, Laws ER, Katznelson L. The role of inferior petrosal sinus sampling in the diagnostic localization of Cushing's disease. Neurosurg Focus. 2007;23(3):E2.

Published In

Neurosurg Focus

DOI

EISSN

1092-0684

Publication Date

2007

Volume

23

Issue

3

Start / End Page

E2

Location

United States

Related Subject Headings

  • Predictive Value of Tests
  • Pituitary ACTH Hypersecretion
  • Petrosal Sinus Sampling
  • Neurology & Neurosurgery
  • Humans
  • Adrenocorticotropic Hormone
  • 3209 Neurosciences
  • 1109 Neurosciences
  • 1103 Clinical Sciences