Skip to main content
NCBI home page
British Medical Journal (Clinical Research Ed.) logoLink to British Medical Journal (Clinical Research Ed.)
. 1982 Jul 24;285(6337):280–282. doi: 10.1136/bmj.285.6337.280

Successful treatment of Cushing's disease using yttrium-90 rods.

M C White, F H Doyle, K Mashiter, G F Joplin
PMCID: PMC1499658  PMID: 6807451

Abstract

Interstitial irradiation using yttrium-90 (90Y) rods implanted by needle into the pituitary gland was used as primary treatment in 16 patients with pituitary dependent Cushing's disease. Clinical and biochemical remission was observed within three or six months in 13 and in the remaining three after a supplementary implant. There was no perioperative morbidity. Follow-up from the time of definitive operation ranged from six to 123 months (mean 39). No recurrence has been observed. The return of a normal diurnal cortisol rhythm has been observed in 10/12 patients studied after remission. Some form of long-term pituitary hormone replacement therapy was required in only the six patients who had received the largest irradiation dose. Implantation of 90Y is safe and effective treatment for patients with Cushing's disease, comparing favourably with selective trans-sphenoidal pituitary surgery.

Full text

PDF
280

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. APPLEBY J. I., GIBSON G., NORYMBERSKI J. K., STUBBS R. D. Indirect analysis of corticosteroids. I. The determination of 17-hydroxycorticosteroids. Biochem J. 1955 Jul;60(3):453–460. doi: 10.1042/bj0600453. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Bigos S. T., Somma M., Rasio E., Eastman R. C., Lanthier A., Johnston H. H., Hardy J. Cushing's disease: management by transsphenoidal pituitary microsurgery. J Clin Endocrinol Metab. 1980 Feb;50(2):348–354. doi: 10.1210/jcem-50-2-348. [DOI] [PubMed] [Google Scholar]
  3. Burke C. W., Doyle F. H., Joplin G. F., Arnot R. N., Macerlean D. P., Fraser T. R. Cushing's disease. Treatment by pituitary implantation of radioactive gold or yttrium seeds. Q J Med. 1973 Oct;42(168):693–714. [PubMed] [Google Scholar]
  4. Carmalt M. H., Dalton G. A., Fletcher R. F., Smith W. T. The treatment of Cushing's disease by trans-sphenoidal hypophysectomy. Q J Med. 1977 Jan;46(181):119–134. [PubMed] [Google Scholar]
  5. Gold E. M. The Cushing syndromes: changing views of diagnosis and treatment. Ann Intern Med. 1979 May;90(5):829–844. doi: 10.7326/0003-4819-90-5-829. [DOI] [PubMed] [Google Scholar]
  6. Harsoulis P., Marshall J. C., Kuku S. F., Burke C. W., London D. R., Fraser T. R. Combined test for assessment of anterior pituitary function. Br Med J. 1973 Nov 10;4(5888):326–329. doi: 10.1136/bmj.4.5888.326. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Jeffcoate W. J., Rees L. H., Tomlin S., Jones A. E., Edwards C. R., Besser G. M. Metyrapone in long-term management of Cushing's disease. Br Med J. 1977 Jul 23;2(6081):215–217. doi: 10.1136/bmj.2.6081.215. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Jennings A. S., Liddle G. W., Orth D. N. Results of treating childhood Cushing's disease with pituitary irradiation. N Engl J Med. 1977 Nov 3;297(18):957–962. doi: 10.1056/NEJM197711032971801. [DOI] [PubMed] [Google Scholar]
  9. Kuwayama A., Kageyama N., Nakane T., Watanabe M., Kanie N. Anterior pituitary function after transsphenoidal selective adenomectomy in patients with Cushing's disease. J Clin Endocrinol Metab. 1981 Jul;53(1):165–173. doi: 10.1210/jcem-53-1-165. [DOI] [PubMed] [Google Scholar]
  10. Lawrence J. H., Tobias C. A., Linfoot J. A., Born J. L., Chong C. Y. Heavy-particle therapy in acromegaly and Cushing disease. JAMA. 1976 May 24;235(21):2307–2310. [PubMed] [Google Scholar]
  11. Lindén V., Rolfsen S. Video computer terminals and occupational dermatitis. Scand J Work Environ Health. 1981 Mar;7(1):62–64. doi: 10.5271/sjweh.2571. [DOI] [PubMed] [Google Scholar]
  12. Nabarro J. D. Pituitary surgery for endocrine disorders. Clin Endocrinol (Oxf) 1980 Sep;13(3):285–298. doi: 10.1111/j.1365-2265.1980.tb01055.x. [DOI] [PubMed] [Google Scholar]
  13. Nilsen A. Facial rash in visual display unit operators. Contact Dermatitis. 1982 Jan;8(1):25–28. doi: 10.1111/j.1600-0536.1982.tb04129.x. [DOI] [PubMed] [Google Scholar]
  14. Orth D. N., Liddle G. W. Results of treatment in 108 patients with Cushing's syndrome. N Engl J Med. 1971 Jul 29;285(5):243–247. doi: 10.1056/NEJM197107292850501. [DOI] [PubMed] [Google Scholar]
  15. Salassa R. M., Laws E. R., Jr, Carpenter P. C., Northcutt R. C. Transsphenoidal removal of pituitary microadenoma in Cushing's disease. Mayo Clin Proc. 1978 Jan;53(1):24–28. [PubMed] [Google Scholar]
  16. Tyrrell J. B., Brooks R. M., Fitzgerald P. A., Cofoid P. B., Forsham P. H., Wilson C. B. Cushing's disease. Selective trans-sphenoidal resection of pituitary microadenomas. N Engl J Med. 1978 Apr 6;298(14):753–758. doi: 10.1056/NEJM197804062981401. [DOI] [PubMed] [Google Scholar]
  17. White M. C., Sanderson J., Mashiter K., Joplin G. F. Gonadotrophin levels in women with Cushing's syndrome before and after treatment. Clin Endocrinol (Oxf) 1981 Jan;14(1):23–29. doi: 10.1111/j.1365-2265.1981.tb00361.x. [DOI] [PubMed] [Google Scholar]
  18. Wrightson P. Conservative removal of small pituitary tumours: is it justified by the pathological findings? J Neurol Neurosurg Psychiatry. 1978 Mar;41(3):283–289. doi: 10.1136/jnnp.41.3.283. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from British Medical Journal (Clinical research ed.) are provided here courtesy of BMJ Publishing Group

RESOURCES