Interesting case of the week: Cushing's Disease with Dr. Tobias Carling

This week we are meeting a young patient suffering from Cushing's Disease. Watch the full video to hear her tell her story. She is now cured. Her cortisol levels are undetectable.
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Cortisol production by the adrenal glands is normally under the control of the pituitary (a small endocrine gland located in the bran right behind your eye). When a pituitary tumor secretes too much ACTH (adrenocorticotropic hormone), it causes the otherwise normal adrenal glands to produce too much cortisol. This type of Cushing's syndrome is termed Cushing's disease.
The treatment for this is pituitary surgery to remove the tumor. When pituitary surgery works (70%), it is great! However, about 1/3 will never be cured in the fist place or the tumor grows back (recurrence). This is a BIG problem.
In these patients removing all cortisol-producing cells, meaning bilateral adrenalectomy is often the best option. The goal is to remove all cells in the adrenal glands overproducing the toxic cortisol.
Many recent studies have shown that bilateral adrenalectomy is an increasingly used and essential treatment option when pituitary surgery is no longer an option. Compared to other options such as radiation or medical treatment, bilateral adrenalectomy lowers morbidity and mortality rates, as well as improves quality-of-life.
Again, the Mini-Back Scope Operation (MBSA) is the best adrenal operation for “failed” ACTH-dependent Cushing’s syndrome, Cushing’s Disease. Do not go through the tummy to get to the adrenal glands!
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