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Adenomectomy was carried out in 41 patients with Icenko-Cushing’s disease. Before surgery, computer-aided tomography showed pituitary adenomas in all the patients. The patients were divided into 2 groups. Group 1 consisted of 31 patients in whom the disease was diagnosed for the first time and group 2 of 10 patients previously treated by other methods (proton ther- ару and unilateral adrenalectomy) without effect. Pituitary adenomas were removed in all patients. Histological study showed hormone-active pituitary adenomas in all cases. The levels of hydrocortisone and ACTH in the plasma and daily urine were increased in both groups before the operation. Ten-twenty days after surgery, the levels of hydrocortisone and ACTH in group 1 were significantly lower than in group 2. We consider that the lower are the levels of these hormones early after surgery, the lower is the probability of a relapse. Postoperative hypocorticalism (10-20 days postoperation) is a good prognostic sign indicating radical removal of pituitary adenoma. Adenomectomy is indicated for patients with Icenko-Cushing’s disease as primary method of treatment.

Treatment of hormone-active pituitary adenomas should be aimed at correcting metabolic disorders without the subsequent development of pituitary hormone deficiency. As a rule, selective adenomectomy is adequate to such requirements. However, intraoperative examination of the pituitary gland is not always successful, even with the use of an operating microscope. Therefore, preoperative detection of the location of pituitary adenoma should be absolutely accurate, which can significantly improve the results of surgical treatment. Prior to 1990, X-ray methods for examining the sella turcica were used only with a small degree of probability to suggest the presence of pituitary microadenomas. The appearance in the 70s of computed tomography (CT) made it possible to significantly improve the topical diagnosis of microadenomas and raise the percentage of their detection to 60-70. The next significant step forward in this direction was the use of magnetic resonance imaging (MRI) since the early 1980s, with the percentage of detection of microadenomas reaching 87. However, in 10-15% of patients with clinical and laboratory manifestations of endocrinopathies, microadenomas cannot be detected. This makes us look for more advanced methods of diagnosis, which include bilateral catheterization of cavernous sinuses (BCCS), with subsequent measurement of the level of hormones in the blood flowing from the pituitary gland.