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Till Burkhardt, Daniel Lüdecke, Lothar Spies, Linus Wittmann, Manfred Westphal and Jörg Flitsch

Alcalar N , Ozkan S , Kadioglu P , Celik O , Cagatay P , Kucukyuruk B , : Evaluation of depression, quality of life and body image in patients with Cushing’s disease . Pituitary 16 : 333 – 340 , 2013 2 Amunts K , Kedo O , Kindler M , Pieperhoff P , Mohlberg H , Shah NJ , : Cytoarchitectonic mapping of the human amygdala, hippocampal region and entorhinal cortex: intersubject variability and probability maps . Anat Embryol (Berl) 210 : 343 – 352 , 2005 3 Andela CD , van der Werff SJ , Pannekoek JN , van den Berg

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Grégoire P. Chatain, Nicholas Patronas, James G. Smirniotopoulos, Martin Piazza, Sarah Benzo, Abhik Ray-Chaudhury, Susmeeta Sharma, Maya Lodish, Lynnette Nieman, Constantine A. Stratakis and Prashant Chittiboina

A ccurate preoperative localization of microadenomas in Cushing’s disease (CD) leads to improved remission rates and decreased adverse events. 3 , 32 Modern MRI modalities including dynamic or volumetric sequences can detect corticotrophic adenomas in 50%–80% of cases of CD. 5 , 6 , 10 , 18 , 23 , 26 Typically, the rest undergo preoperative inferior petrosal sinus sampling (IPSS) to confirm a pituitary source of adrenocorticotropic hormone (ACTH)–dependent hypercortisolemia in patients with negative MRI findings. 8 , 35 The IPSS, however, does not improve

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Amitabh Gupta, Zhiyuan Xu, Hideyuki Kano, Nathaniel Sisterson, Yan-Hua Su, Michal Krsek, Ahmed M. Nabeel, Amr El-Shehaby, Khaled A. Karim, Nuria Martínez-Moreno, David Mathieu, Brendan J. McShane, Roberto Martínez-Álvarez, Wael A. Reda, Roman Liscak, Cheng-Chia Lee, L. Dade Lunsford and Jason P. Sheehan

E xcessive secretion of pituitary hormones, such as adrenocorticotropic hormone (ACTH) in Cushing’s disease (CD) and growth hormone (GH) causing acromegaly, may lead to serious endocrine complications if left untreated. Both are associated with significant systemic sequelae and an increased susceptibility to other medical conditions. These sequelae include increased mortality from cardiovascular and cerebrovascular disease, as well as increased morbidity from diabetes mellitus, hypertension, and psychological disturbances. 2 , 9 , 13 , 30 , 40 Moreover, if left

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Panagiotis Mastorakos, Davis G. Taylor, Ching-Jen Chen, Thomas Buell, Joseph H. Donahue and John A. Jane Jr.

C avernous sinus invasion (CSI) in Cushing’s disease (CD) is associated with reduced incidence of gross-total resection and endocrine remission, increased morbidity, and need for adjuvant therapy. 1 , 10 , 21 Invasion of the cavernous sinus (CS) by pituitary adenomas based on MRI has been inconsistent and variable, with no single method demonstrating an ability to accurately predict CSI, even among macroadenomas (in which CSI is more common). 4 , 7 Unlike other pituitary adenomas that typically present as macroadenomas, CD is more likely to present while the

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Adomas Bunevicius, Hideyuki Kano, Cheng-Chia Lee, Michal Krsek, Ahmed M. Nabeel, Amr El-Shehaby, Khaled Abdel Karim, Nuria Martinez-Moreno, David Mathieu, John Y. K. Lee, Inga Grills, Douglas Kondziolka, Roberto Martinez-Alvarez, Wael A. Reda, Roman Liscak, Yan-Hua Su, L. Dade Lunsford, Mary Lee Vance and Jason P. Sheehan

submitted version of manuscript: all authors. Approved the final version of the manuscript on behalf of all authors: Sheehan. Statistical analysis: Bunevicius, Krsek. Administrative/technical/material support: Sheehan. Study supervision: Sheehan. References 1 Aghi MK : Management of recurrent and refractory Cushing disease . Nat Clin Pract Endocrinol Metab 4 : 560 – 568 , 2008 2 Clayton RN , Jones PW , Reulen RC , Stewart PM , Hassan-Smith ZK , Ntali G , : Mortality in patients with Cushing’s disease more than 10 years after remission: a

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Meng Law, Regina Wang, Chia-Shang J. Liu, Mark S. Shiroishi, John D. Carmichael, William J. Mack, Martin Weiss, Danny J. J. Wang, Arthur W. Toga and Gabriel Zada

E ndogenous Cushing’s syndrome is a physical state characterized by excessive blood levels of cortisol. The most common form of endogenous Cushing’s syndrome, Cushing’s disease, is caused by an adrenocorticotrophic hormone (ACTH)–producing adenoma in the pituitary gland. A pituitary adenoma is responsible for 80%–85% of ACTH-dependent Cushing’s syndrome, where ACTH oversecretion causes the adrenal gland to secrete excessive amounts of cortisol. 10 Corticotroph adenomas are often microadenomas, which may be difficult to diagnose due to challenges with the

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Adomas Bunevicius, Darrah Sheehan, Mary Lee Vance, David Schlesinger and Jason P. Sheehan

II , Carter BS , Ojemann RG , Jyung RW , Poe DS , McKenna MJ : Surgical excision of acoustic neuroma: patient outcome and provider caseload . Laryngoscope 113 : 1332 – 1343 , 2003 3 Clayton RN , Jones PW , Reulen RC , Stewart PM , Hassan-Smith ZK , Ntali G , : Mortality in patients with Cushing’s disease more than 10 years after remission: a multicentre, multinational, retrospective cohort study . Lancet Diabetes Endocrinol 4 : 569 – 576 , 2016 4 Fatemi N , Dusick JR , de Paiva Neto MA , Kelly DF : The

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Marc Mayberg, Stephen Reintjes, Anika Patel, Kelley Moloney, Jennifer Mercado, Alex Carlson, James Scanlan and Frances Broyles

R esection by transsphenoidal adenomectomy (TSA) remains the treatment of choice for Cushing’s disease (CD) due to adrenocorticotropin hormone (ACTH)–secreting pituitary adenomas. 18 More than 90% of patients with CD harbor pituitary microadenomas, 10 and numerous reports have described postoperative remission rates of 60%–90%, 7 , 12 , 19 , 32 , 33 with late recurrence in 10%–65% of patients. 2 , 4 , 5 Factors associated with unsuccessful surgery for CD include larger tumor size, 13 , 27 absence of tumor on MRI, 11 , 31 previous transsphenoidal surgery, 9

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Bo Hou, Lu Gao, Lin Shi, Yishan Luo, Xiaopeng Guo, Geoffrey S. Young, Lei Qin, Huijuan Zhu, Lin Lu, Zihao Wang, Ming Feng, Xinjie Bao, Renzhi Wang, Bing Xing and Feng Feng

– 776 , 2019 2 Andela CD , van der Werff SJ , Pannekoek JN , van den Berg SM , Meijer OC , van Buchem MA , : Smaller grey matter volumes in the anterior cingulate cortex and greater cerebellar volumes in patients with long-term remission of Cushing’s disease: a case-control study . Eur J Endocrinol 169 : 811 – 819 , 2013 3 Andela CD , van Haalen FM , Ragnarsson O , Papakokkinou E , Johannsson G , Santos A , : Mechanisms in endocrinology: Cushing’s syndrome causes irreversible effects on the human brain: a systematic review of

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Steven B. Carr, Bette K. Kleinschmidt-DeMasters, Janice M. Kerr, Katja Kiseljak-Vassiliades, Margaret E. Wierman and Kevin O. Lillehei

H ypercortisolism from an adrenocorticotropic hormone (ACTH)–secreting pituitary tumor, also known as Cushing’s disease (CD), is an endocrinopathy with significant associated morbidity and mortality. Patients exposed to chronic hypercortisolism are prone to multiple metabolic, cardiovascular, and infectious risks, including hypertension, diabetes mellitus, opportunistic infections, hyperlipidemia, and hypercoagulability. Untreated, CD is associated with upwards of a 5.5-fold increased mortality risk. 12 The most common cause of CD is an ACTH-secreting pituitary