Summary
Nelson's syndrome is rare and difficult to cure. The tumours in this condition may behave invasively and require multiple interventions.
Two patients who had been followed up for nearly 20 years developed signs of cavernous sinus involvement, one with an empty sella.
Long term follow-up for such patients is emphasized.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Ahmadi J, North SM, Segal HD, Chi-Sing Z, Weiss MH (1985) Cavernous sinus invasion by pituitary tumours. AJNR 6: 893–898
Aron DC, Findling JW, Tyrrel B (1987) Cushing's disease. Endocrinol Metab Clin North Am 16.3: 705–731
Barwich D, Baher F (1978) Pituitary tumours in adrenalectomized patients with Cushing's disease. In: Fahlbusch R, von Werder K (eds) Treatment of pituitary adenomas (1st European Workshop at Rottach-Egern). Georg Thieme, Stuttgart, pp 326–330
Buchfelder M, Fahlbush R (1987) Transsphenoidal surgery of pituitary adenomas developed towards the cavernous sinus. In: Dolenc VV (ed) The cavernous sinus. Springer, Wien New York, pp 404–414
Dolenc VV, Kregar TR, Fergula M, Foltich M, Marina A(1987) Treatment of tumours invading the cavernous sinus. In: Dolenc VV (ed) The cavernous sinus. Springer, Wien New York, pp 377–391
Dominigue JN, Wing SD, Wilson CB (1978) Co-existing pituitary adenoma and partially empty sella. J Neurosurg 48: 23–28
Fukushima T (1985) Transsphenoidal microsurgical treatment of Nelson's syndrome. Neurosurg Rev 8: 185–194
Halberg FE, Sheline GE (1987) Radiotherapy of pituitary tumours. Endocrinol Metab Clin North Am 16.3: 667–684
Kucharczyk W, Davis D, Kelly W, Sze G, Norman D, Newton T. (1986) Pituitary adenoma. High resolution MR imaging at 1.5T. Radiology 161 (3): 761–765
Laws ER (1987) Pituitary surgery. Endocrinol Metab Clin North Am 16.3: 647–667
Lüdecke DK, Breustedt HJ, Brunswig J, Kobberling J, Saeger W (1982) Evaluation of surgically treated Nelson's syndrome. Arch Neurochir (Wien) 65: 3–13
MacKay A, Hosobuchi Y (1978) Treatment of intracavernous extensions of pituitary adenomas. Surg Neurol 10: 377–383
Mampalam TJ, Tyrrell JB (1988) Transsphenoidal microsurgery for Cushing's disease: a report of 216 cases. Ann Intern Med 109: 487–493
Moore TJ, Dluhy RG, Williams GH, Cain JP (1976) Nelson's syndrome: frequency, prognosis and effect of prior pituitary irradiation. Ann Inter Med 85: 731–734
Nelson DH, Meakin JW, Deally DD, Matson K, Emerson K, Thorn GW (1958) ACTH-producing tumours of the pituitary gland. N Engl J Med 259: 161–164
Robert E, Pelletier G, Hardy J (1978) Pituitary adenoma in Cushing's disease: a histologic, ultrastructural and immunochemical study. Arch Path Lab Medicine 102: 448–455
Rovitt RL, Duanne TD (1969) Cushing's syndrome and pituitary tumours. Pathophysiology and ocular manifestations of ACTH-secreting pituitary adenomas. Am J Med 46: 416–427
Salassa RM, Kearns TP, Kernohan JW, Sprague RG, MacCarry CS (1959) Pituitary tumours in patients with Cushing's syndrome. J Clin Endocrinol Metab 19: 1523–1539
Scheithauer BW (1984) Surgical pathology of the pituitary: the adenomas. Part II. Path Annu 19: 269–329
Scheithauer BW, Kovacs KT, Laws ER, Randall RV (1986) Pathology of invasive pituitary with special reference to functional classification. J Neurosurg 65: 733–805
Scotti G, Yu CY, Dillon WP, Norman D, Colombo N, Newton TH, DeGroot J, Wilson CB (1988) MR imaging of cavernous sinus involvement by pituitary adenomas. AJR 151(4): 799–805
Sekhar LN, Moller AR (1986) Operative management of tumours involving the cavernous sinus. J Neurosurg 64: 879–889
Sellman WR, Laws ER Jr, Scheithauer BW, Carpenter SH (1986) The occurrence of dural invasion in pituitary adenomas. J Neurosurg 64: 402–407
Symon L, Jackubowski J, Kendall B (1979) Surgical treatment of giant pituitary adenomas. J Neurol Neurosurg Psychiatry 42: 973–983
Wilson CB, Dempsey LC (1978) Transsphenoidal microsurgical removal of 250 pituitary adenomas. J Neurosurg 48: 13–22
Wilson CB, Tyrell JB, Fitzgerald PA, Pitts LH (1980) Cushing's disease and Nelson's syndrome. Clin Neurosurg 27: 19–30
Wilson CB (1979) Surgical management of pituitary tumour. In: Tindall ST, Collins WF (eds) Clinical management of pituitary disorders. Raven, New York, pp 335–342
Wilaski J, Kasperlik-Zaluka AA, Jeske W, Migdalska B, Janik JM, Zaluka J, Bonicki W (1985) Results of neurosurgical treatment by a transsphenoidal approach in 10 patients with Nelson's syndrome. J Neurosurg 62: 68–71
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Sett, P.K., Crockard, H.A., Powell, M. et al. Cavernous sinus involvement in recurrent Nelson's syndrome. Acta neurochir 104, 69–72 (1990). https://doi.org/10.1007/BF01842897
Issue Date:
DOI: https://doi.org/10.1007/BF01842897