Evidence map›Paper›PMID 40090938›Full record

ArticleChild's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery2025

Clinical and surgical outcomes of pediatric Cushing's disease following endoscopic transsphenoidal surgery.

Guive Sharifi, Elham Paraandavaji, Mohammad Mehdi Mousavi Nasab, Esmaeil Mohammadi, Neginalsadat Sadeghi, Seyed Mohammad Tavangar, Mohammad Reza Mohajeri Tehrani, Nader Akbari Dilmaghani

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Article in Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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1 · What the graph read from it

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3 · Its place in the literature

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2 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Guive SharifiDepartment of Neurosurgery, Loghman Hospital, Shahid Beheshti University of Medical Science, Tehran, Iran.
Elham ParaandavajiSkull Base Research Center, Loghman Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Mohammad Mehdi Mousavi NasabSkull Base Research Center, Loghman Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Esmaeil MohammadiDepartment of Neurosurgery, Tehran University of Medical Sciences, Enghelab Sq, Tehran, 141746-6191, Iran. EsmaeilMuhammadi@gmail.com.
Neginalsadat SadeghiFarhikhtegan Medical Convergence Sciences Research Center, Farhikhtegan Hospital Tehran Medical Sciences, Islamic Azad University, Tehran, Iran.
Seyed Mohammad TavangarEndocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
Mohammad Reza Mohajeri TehraniEndocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
Nader Akbari DilmaghaniSkull Base Research Center, Loghman Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCushing's disease (CD) is characterized by hypercortisolism due to excessive adrenocorticotropic hormone (ACTH) secretion from a pituitary adenoma. Though more common in adults, pediatric cases constitute approximately 5% of those seen in adults. Early diagnosis and treatment are critical due to the severe impacts on growth and development in children. Endoscopic transsphenoidal surgery (ETSS) is the preferred first-line treatment for both children and adults.

methodsFrom 2011 to 2024, 3280 patients with pituitary adenoma underwent surgery using the ETSS technique at Loghman Hospital of Tehran, including 213 CD cases, of which 22 were pediatric (under 18 years old). This retrospective study analyzed clinical data such as age, gender, presenting symptoms, family and medical history, imaging characteristics, surgical findings, pathology, follow-up, and postoperative outcomes. Diagnostic criteria included biochemical tests, MRI imaging, and inferior petrosal sinus sampling.

resultsOut of 22 pediatric patients, 16 were females and 6 males, with an average age of 14.73 years. Obesity was the initial clinical manifestation in 59% of the patients. According to the Hardy-Wilson classification, 18.2% of patients were stage E, 9.09% stage C, and the rest (excluding MRI-negative patients) stage A. ETSS was performed on all patients, with total hypophysectomy in 18.2% and hemi-hypophysectomy in 9.09%. Postoperative complications included cerebrospinal fluid leakage in 13.63% of patients. Remission was achieved in 95.45% of patients, with a recurrence rate of 4.54%. Hormone imbalances post-surgery included hypocortisolism (50%), hypothyroidism (45.45%), and hypogonadism (13.63%).

conclusionETSS is an effective and safe treatment for pediatric CD, achieving high remission rates and minimal complications. This study highlights the importance of specialized surgical care in managing pediatric CD and underscores the need for early diagnosis and intervention. Further studies are warranted to evaluate long-term outcomes and optimize treatment protocols.

Indexed as

AdenomaNeuroendoscopyPituitary ACTH HypersecretionPituitary NeoplasmsAdolescentChildFemaleHumansMaleRetrospective StudiesTreatment OutcomeCushing’s diseaseEndoscopic transsphenoidal surgeryHypercortisolismPediatric endocrinologyPituitary adenomaSurgical outcomes

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PMID40090938

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