SynthesisEuropean journal of endocrinology2021
Corticotroph tumor progression after bilateral adrenalectomy (Nelson's syndrome): systematic review and expert consensus recommendations.
Synthesis in European journal of endocrinology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 3 of them syntheses that pooled it.
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Who cites it
29 citing papers in PubMed, 3 syntheses or guidelines pooled it, 55 citations in OpenAlex.
- Outcomes of stereotactic radiosurgery in nelson's syndrome: a systematic review and Meta-Analysis.Pituitary · 2025Pooled it
- Consensus guideline for the diagnosis and management of pituitary adenomas in childhood and adolescence: Part 2, specific diseases.Nature reviews. Endocrinology · 2024Guideline
- Prevalence of Nelson's syndrome after bilateral adrenalectomy in patients with cushing's disease: a systematic review and meta-analysis.Pituitary · 2021Pooled it
- Corticotroph Tumour Progression 37 Years After Bilateral Adrenalectomy with Temozolomide-Naive Response to Pembrolizumab.Endocrine oncology (Bristol, England) · 2026Article
- A case of Nelson's syndrome with adrenal crisis occurring 21 years post-adrenalectomy for Cushing's disease.BMC endocrine disorders · 2026Article
- Use of osilodrostat in a block-and-replace and titration strategy for cushing's syndrome: a position paper by French experts.Reviews in endocrine & metabolic disorders · 2026Article
- Adrenal causes of endocrine hypertension in childhood or adolescence.Journal of endocrinological investigation · 2025Review
- Clinical presentation, predictive factors and management of patients with Nelson syndrome: a retrospective study.Pituitary · 2025Article
- Stereotactic radiosurgery and fractionated radiation therapy in the management of pituitary tumors.Neuro-oncology advances · 2025Article
- Cushing syndrome.Nature reviews. Disease primers · 2025Review
- Insights on epidemiology, morbidity and mortality of Cushing's disease in Northern Ireland.Endocrine-related cancer · 2024Article
- Seliciclib: A New Treatment for Cushing's Disease?TouchREVIEWS in endocrinology · 2024Article
- Paediatric Cushing's disease: long-term outcome and predictors of recurrence.Frontiers in endocrinology · 2024Review
- Complications and mortality of Cushing's disease: report on data collected over a 20-year period at a referral centre.Pituitary · 2023Article
- An individualized approach to the management of Cushing disease.Nature reviews. Endocrinology · 2023Review
- Aggressive Pituitary Tumors and Pituitary Carcinomas: From Pathology to Treatment.The Journal of clinical endocrinology and metabolism · 2023Article
- Refractory corticotroph adenomas.Pituitary · 2023Review
- Nelson's Syndrome: A Narrative Review.Cureus · 2023Review
- Renin and electrolytes indicate the mineralocorticoid activity of fludrocortisone: a 6 year study in primary adrenal insufficiency.Journal of endocrinological investigation · 2023Article
- Reoperation for Recurrent and Persistent Cushing's Disease without Visible MRI Findings.Journal of clinical medicine · 2022Article
Corrections and comments
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Authors and funding
36 authors at 20 institutions in 10 countries.
Funding
Abstract
backgroundCorticotroph tumor progression (CTP) leading to Nelson's syndrome (NS) is a severe and difficult-to-treat complication subsequent to bilateral adrenalectomy (BADX) for Cushing's disease. Its characteristics are not well described, and consensus recommendations for diagnosis and treatment are missing.
methodsA systematic literature search was performed focusing on clinical studies and case series (≥5 patients). Definition, cumulative incidence, treatment and long-term outcomes of CTP/NS after BADX were analyzed using descriptive statistics. The results were presented and discussed at an interdisciplinary consensus workshop attended by international pituitary experts in Munich on October 28, 2018.
resultsData covered definition and cumulative incidence (34 studies, 1275 patients), surgical outcome (12 studies, 187 patients), outcome of radiation therapy (21 studies, 273 patients), and medical therapy (15 studies, 72 patients).
conclusionsWe endorse the definition of CTP-BADX/NS as radiological progression or new detection of a pituitary tumor on thin-section MRI. We recommend surveillance by MRI after 3 months and every 12 months for the first 3 years after BADX. Subsequently, we suggest clinical evaluation every 12 months and MRI at increasing intervals every 2-4 years (depending on ACTH and clinical parameters). We recommend pituitary surgery as first-line therapy in patients with CTP-BADX/NS. Surgery should be performed before extrasellar expansion of the tumor to obtain complete and long-term remission. Conventional radiotherapy or stereotactic radiosurgery should be utilized as second-line treatment for remnant tumor tissue showing extrasellar extension.
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