Cushing's Syndrome and Skin Pigmentation

Mason, April C.; Greenbaum, David S.

doi:10.1136/bmj.2.5302.445

Cited by 11 publications

(4 citation statements)

References 16 publications

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“…Although it is estimated by the previous literature [8,10,13,15,16,20,28,32,37,39,46,54] that 5 to 20% of adrenalectomized Cushing patients will develop pituitary tumours, the true prevalence has been unclear. The relatively low incidence of detecting Nelson's adenoma in the past is solely due to the lack of precise neurodiagnostic techniques, taking only symptomatic macroadenomas.…”

Section: Incidence Of Nelson's Syndromementioning

confidence: 96%

“…Since the first description of this remarkable syndrome by Nelson et al [35], there have been a number of papers reporting detailed clinical features [13,16,28,29,30,32,37,41]. Patients with Nelson's syndrome show progressive intense pigmentation of skin and mucous membranes.…”

Section: Clinical Features Of Nelson's Syndromementioning

confidence: 98%

“…After this report, Robert M. Salassa and his colleagues of the Mayo Clinic [41] published a paper in 1959 with a detailed clinical survey of 12 similar cases. Since then, many other © 1985 by Walter de Gruyter & Co. Berlin -New York cases have been reported in the medical literatur [13,16,28,29,30] and this unique condition ha been termed Nelson's syndrome or Nelson-Salass syndrome. It is characterized by the clinical triad o progressive cutaneous hyperpigmentation, markedl I elevated plasma ACTH activity and an enlargeq sella turcica.…”

Section: Introductionmentioning

confidence: 98%

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Trans-sphenoidal microsurgical treatment of Nelson's syndrome

Fukushima

1985

Neurosurg. Rev.

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Clinical features and the operative results in the author's personal series of ten cases with Nelson's syndrome are presented. There were nine females and one male patient with ages ranging from 20 to 44 years (mean 36 y). All patients presented with typical hyperpigmentation of the skin and had abnormally raised plasma ACTH levels. X-ray polytomography detected sellar abnormalities in 80% of the cases. Computerized tomography was positive for pituitary tumour in three patients. Trans-sphenoidal microsurgical removal of Nelson's ACTH adenomas were successful in seven of ten patients. The operative technique of radical-selective resection to achieve endocrinological cure is described. Pertinent literature is reviewed and the incidence of Nelson's syndrome, an issue of controversies regarding the pathogenesis, and the management of Nelson's adenomas are discussed.

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Section: Incidence Of Nelson's Syndromementioning

confidence: 96%

Section: Clinical Features Of Nelson's Syndromementioning

confidence: 98%

Section: Introductionmentioning

confidence: 98%

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Trans-sphenoidal microsurgical treatment of Nelson's syndrome

Fukushima

1985

Neurosurg. Rev.

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“…The clinical manifestations of the hyperthyroidism were also to some extent masked and the original suspicions were confirmed by the pronounced depression of the pulse rate during the administration of potassium iodide in connexion with the '''1 albumin study. There was some pigmentation unusual in Cushing's syndrome (16), in which condition it may indicate the presence of a pituitary adenoma (61) or carcinoma (29). In hyperthyroidism such pigmentation, in the author's experience, is sometimes really intense, and it has been shown that the disappearance of intravenously admi-nistered cortisol is even more rapid in hyperthyroid patients with pigmentation (46).…”

Section: Discussionmentioning

confidence: 99%