How is corticotropinoma treated in hyperpituitarism?

Updated: Oct 24, 2016
  • Author: Alicia Diaz-Thomas, MD, MPH; Chief Editor: Robert P Hoffman, MD  more...
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The treatment of choice for patients with Cushing disease is transsphenoidal microsurgery. Medical therapy for Cushing disease is adjunctive only. The goal is to inhibit the enzymes responsible for cortisol synthesis with adrenal enzyme inhibitors, such as metyrapone, aminoglutethimide, and ketoconazole. Metyrapone and aminoglutethimide have been the standard therapy, and, when the 2 agents are used in combination, adverse effects may be decreased. Ketoconazole, a broad-spectrum antimycotic drug, inhibits adrenal steroid biosynthesis at several sites, including side chain cleavage and 11B-hydroxylation. Occasionally, patients with ACTH-secreting tumors respond to bromocriptine.

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