Gamma Knife Radiosurgery For Cushing Disease

Mariko Nagai1

1Tokyo Womens Medical University, Tokyo, Japan

Keywords: Cushing's disease, pituitary adenoma, gamma knife, outcome, hormone dysfunction

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     More than 20,000 pituitary adenomas have already been treated by Gamma Knife Surgery (GKS) worldwide. Among them, most difficult type is one which invades the cavernous sinus.
     We report some of the cases treated by our original method.
     Since December 2001 to May 2009, 17 patients with ACTH producing tumors were treated at our institute. 4 of them experienced repeat GKS.
     At treatment, constructive interference in steady state with gadolinium was used for MRI to achieve clear visualization of the tumors and critical surrounding structures. Average dose of 26.6 Gy (range: 12-35 Gy) was used.
     The average follow-up was 34.8 months (range: 6-78). Tumor volume control rate was 100% and shrinkage rate was 71.4%. Hormonal normalization rate was 50%, and improvement was observed in 42.9%. Two patients experienced complications; one had oculomotor palsy and the other had abducent palsy.
     This is a retrospective study.
     It is possible to control not only the tumor volume. 
     It is possible to also decrease the volume and normalize hormonal condition by keeping high intratumoral isodose.


Project Roles:

M. Nagai ()