Year 2021, Volume 7 , Issue 1, Pages 100 - 106 2021-01-04

Reliability of cavernous sinus sampling in management of Cushing’s disease

Mahmut ÇAMLAR [1] , Burak KINALI [2] , Necmettin TANRIÖVER [3] , Pınar KADIOĞLU [4] , Seçil ERDEN [5] , Civan ISLAK [6] , Naci KOCER [7] , Osman KIZILKILIC [8] , Meryem ÖREN [9] , Nurperi GAZİOĞLU [10]


Objectives: The purpose of this study is to find out the accuracy of bilateral cavernous sinus sampling (CSS) for preoperative tumor lateralization within the pituitary in Cushing’s disease (CD).

Methods: Sixty-five patients who had undergone transsphenoidal surgery (TSS) following CSS for CD between 2000-2016 at our institution were analyzed retrospectively. All patients underwent bilaterally CSS with corticotropin-releasing hormone (CRH) stimulation. Radiological, preoperative, and pathological findings with remission status were correlated with CSS data. The accuracy of CSS is decided according to compliance with the magnetic resonance imaging (MRI), pathology or remission after surgery of the normal MRI cases.

Results: CSS indicated the correct lateralization in 52 (80%) patients. There was the same level elevation of both sides in 3 patients who had central adenoma. Remission rate in the final follow-up was 83.87% for 65 patients. We found out the contralateral pathological side in 13 (20%) of the patients showing false lateralization. Twenty-four patients with normal MRI had a positive accuracy rate of 83%. Of those patients, with a positive accuracy of CSS sampling, 18 (90%) had a positive remission. As a result of the Kappa analysis, statistically significance and relation was found between the final diagnosis and lateralization test (κ=0,63 p < 0.001).

Conclusions: Our results showed that CSS is a safe and reliable method for microadenomas which has high diagnostic accuracy (80%) in indicating the correct lateralization in CD, providing us higher remission rates in a challenging pathology. 

Cushing’s disease, pituitary tumor, Adrenocorticotropic hormone, Cavernous sinus sampling, Venous sampling
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Primary Language en
Subjects Neurosciences, Radiology, Nuclear Medicine, Medical Imaging
Journal Section Original Articles
Authors

Orcid: 0000-0002-6467-0172
Author: Mahmut ÇAMLAR
Institution: Department of Neurosurgery, University of Health Sciences, İzmir Tepecik Training and Research Hospital, İzmir, Turkey
Country: Turkey


Orcid: 0000-0002-1124-6888
Author: Burak KINALI
Institution: Department of Neurosurgery, University of Health Sciences, İzmir Tepecik Training and Research Hospital, İzmir, Turkey
Country: Turkey


Orcid: 0000-0001-7628-9443
Author: Necmettin TANRIÖVER
Institution: Department of Neurosurgery, İstanbul University-Cerrahpaşa, Cerrahpaşa School of Medicine, İstanbul, Turkey
Country: Turkey


Orcid: 0000-0002-8329-140X
Author: Pınar KADIOĞLU
Institution: Department of Internal Medicine, Division of Endocrinology-Metabolism and Diabetes, İstanbul University-Cerrahpaşa, Cerrahpaşa School of Medicine, İstanbul, Turkey
Country: Turkey


Orcid: 0000-0002-4931-3599
Author: Seçil ERDEN
Institution: Department of Fundamentals of Nursing, İstanbul University-Cerrahpaşa, Florance Nightingale Faculty of Nursing, İstanbul, Turkey
Country: Turkey


Orcid: 0000-0002-3626-6244
Author: Civan ISLAK
Institution: Department of Neuroradiology, İstanbul University-Cerrahpaşa, Cerrahpaşa School of Medicine, İstanbul, Turkey
Country: Turkey


Orcid: 0000-0003-0884-6492
Author: Naci KOCER
Institution: Department of Neuroradiology, İstanbul University-Cerrahpaşa, Cerrahpaşa School of Medicine, İstanbul, Turkey
Country: Turkey


Orcid: 0000-0002-6620-8934
Author: Osman KIZILKILIC
Institution: Department of Neuroradiology, İstanbul University-Cerrahpaşa, Cerrahpaşa School of Medicine, İstanbul, Turkey
Country: Turkey


Orcid: 0000-0002-3383-7830
Author: Meryem ÖREN
Institution: Department of Public Health Services Presidency, Erzurum Provincial Health Directorate, Erzurum, Turkey
Country: Turkey


Orcid: 0000-0001-7785-8628
Author: Nurperi GAZİOĞLU (Primary Author)
Institution: Department of Neurosurgery, İstanbul Bilim University School of Medicine, İstanbul, Turkey
Country: Turkey


Supporting Institution Yok
Project Number Yok
Dates

Application Date : July 12, 2020
Acceptance Date : September 8, 2020
Publication Date : January 4, 2021

EndNote %0 The European Research Journal Reliability of cavernous sinus sampling in management of Cushing’s disease %A Mahmut Çamlar , Burak Kınalı , Necmettin Tanrıöver , Pınar Kadıoğlu , Seçil Erden , Civan Islak , Naci Kocer , Osman Kızılkılıc , Meryem Ören , Nurperi Gazi̇oğlu %T Reliability of cavernous sinus sampling in management of Cushing’s disease %D 2021 %J The European Research Journal %P -2149-3189 %V 7 %N 1 %R doi: 10.18621/eurj.763928 %U 10.18621/eurj.763928