Preoperative lateralization of ACTH-secreting pituitary microadenomas by bilateral and simultaneous inferior petrosal venous sinus sampling

E. H. Oldfield, G. P. Chrousos, H. M. Schulte, M. Schaaf, P. E. McKeever, A. G. Krudy, G. B. Cutler, Donald (Lynn) Loriaux, J. L. Doppman

Research output: Contribution to journalArticle

194 Citations (Scopus)

Abstract

In this study we correlated ACTH concentrations measured simultaneously in blood from both the inferior petrosal sinuses with the operative findings and clinical outcome in 15 patients with Cushing's syndrome. Of 10 patients with microadenomas, 7 had higher ACTH levels in the inferior petrosal sinus on the side where a microadenoma was later found and resected during transsphenoidal surgery. The other three patients, in whom no adenoma was found at surgery, were cured by removal of the half of the gland releasing larger amounts of ACTH. Thus, bilateral simultaneous blood sampling from the inferior petrosal sinuses and a peripheral vein to determine ACTH concentrations consistently predicted the position of the microadenoma in the pituitary gland and allowed surgical cure even in patients with no identifiable adenoma. Furthermore, 7 of 10 patients with microadenomas had ACTH levels in the enferior petrosal sinus contralateral to the adenoma that were the same as peripheral levels of ACTH. If blood had been sampled on this side only, as is common practice, the findings would have suggested an ectopic source of ACTH.

Original languageEnglish (US)
Pages (from-to)100-103
Number of pages4
JournalNew England Journal of Medicine
Volume312
Issue number2
StatePublished - 1985
Externally publishedYes

Fingerprint

Petrosal Sinus Sampling
Adrenocorticotropic Hormone
Adenoma
Cushing Syndrome
Pituitary Gland
Veins

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Oldfield, E. H., Chrousos, G. P., Schulte, H. M., Schaaf, M., McKeever, P. E., Krudy, A. G., ... Doppman, J. L. (1985). Preoperative lateralization of ACTH-secreting pituitary microadenomas by bilateral and simultaneous inferior petrosal venous sinus sampling. New England Journal of Medicine, 312(2), 100-103.

Preoperative lateralization of ACTH-secreting pituitary microadenomas by bilateral and simultaneous inferior petrosal venous sinus sampling. / Oldfield, E. H.; Chrousos, G. P.; Schulte, H. M.; Schaaf, M.; McKeever, P. E.; Krudy, A. G.; Cutler, G. B.; Loriaux, Donald (Lynn); Doppman, J. L.

In: New England Journal of Medicine, Vol. 312, No. 2, 1985, p. 100-103.

Research output: Contribution to journalArticle

Oldfield, EH, Chrousos, GP, Schulte, HM, Schaaf, M, McKeever, PE, Krudy, AG, Cutler, GB, Loriaux, DL & Doppman, JL 1985, 'Preoperative lateralization of ACTH-secreting pituitary microadenomas by bilateral and simultaneous inferior petrosal venous sinus sampling', New England Journal of Medicine, vol. 312, no. 2, pp. 100-103.
Oldfield, E. H. ; Chrousos, G. P. ; Schulte, H. M. ; Schaaf, M. ; McKeever, P. E. ; Krudy, A. G. ; Cutler, G. B. ; Loriaux, Donald (Lynn) ; Doppman, J. L. / Preoperative lateralization of ACTH-secreting pituitary microadenomas by bilateral and simultaneous inferior petrosal venous sinus sampling. In: New England Journal of Medicine. 1985 ; Vol. 312, No. 2. pp. 100-103.
@article{8b500a51ac7645f993d8606fff333578,
title = "Preoperative lateralization of ACTH-secreting pituitary microadenomas by bilateral and simultaneous inferior petrosal venous sinus sampling",
abstract = "In this study we correlated ACTH concentrations measured simultaneously in blood from both the inferior petrosal sinuses with the operative findings and clinical outcome in 15 patients with Cushing's syndrome. Of 10 patients with microadenomas, 7 had higher ACTH levels in the inferior petrosal sinus on the side where a microadenoma was later found and resected during transsphenoidal surgery. The other three patients, in whom no adenoma was found at surgery, were cured by removal of the half of the gland releasing larger amounts of ACTH. Thus, bilateral simultaneous blood sampling from the inferior petrosal sinuses and a peripheral vein to determine ACTH concentrations consistently predicted the position of the microadenoma in the pituitary gland and allowed surgical cure even in patients with no identifiable adenoma. Furthermore, 7 of 10 patients with microadenomas had ACTH levels in the enferior petrosal sinus contralateral to the adenoma that were the same as peripheral levels of ACTH. If blood had been sampled on this side only, as is common practice, the findings would have suggested an ectopic source of ACTH.",
author = "Oldfield, {E. H.} and Chrousos, {G. P.} and Schulte, {H. M.} and M. Schaaf and McKeever, {P. E.} and Krudy, {A. G.} and Cutler, {G. B.} and Loriaux, {Donald (Lynn)} and Doppman, {J. L.}",
year = "1985",
language = "English (US)",
volume = "312",
pages = "100--103",
journal = "New England Journal of Medicine",
issn = "0028-4793",
publisher = "Massachussetts Medical Society",
number = "2",

}

TY - JOUR

T1 - Preoperative lateralization of ACTH-secreting pituitary microadenomas by bilateral and simultaneous inferior petrosal venous sinus sampling

AU - Oldfield, E. H.

AU - Chrousos, G. P.

AU - Schulte, H. M.

AU - Schaaf, M.

AU - McKeever, P. E.

AU - Krudy, A. G.

AU - Cutler, G. B.

AU - Loriaux, Donald (Lynn)

AU - Doppman, J. L.

PY - 1985

Y1 - 1985

N2 - In this study we correlated ACTH concentrations measured simultaneously in blood from both the inferior petrosal sinuses with the operative findings and clinical outcome in 15 patients with Cushing's syndrome. Of 10 patients with microadenomas, 7 had higher ACTH levels in the inferior petrosal sinus on the side where a microadenoma was later found and resected during transsphenoidal surgery. The other three patients, in whom no adenoma was found at surgery, were cured by removal of the half of the gland releasing larger amounts of ACTH. Thus, bilateral simultaneous blood sampling from the inferior petrosal sinuses and a peripheral vein to determine ACTH concentrations consistently predicted the position of the microadenoma in the pituitary gland and allowed surgical cure even in patients with no identifiable adenoma. Furthermore, 7 of 10 patients with microadenomas had ACTH levels in the enferior petrosal sinus contralateral to the adenoma that were the same as peripheral levels of ACTH. If blood had been sampled on this side only, as is common practice, the findings would have suggested an ectopic source of ACTH.

AB - In this study we correlated ACTH concentrations measured simultaneously in blood from both the inferior petrosal sinuses with the operative findings and clinical outcome in 15 patients with Cushing's syndrome. Of 10 patients with microadenomas, 7 had higher ACTH levels in the inferior petrosal sinus on the side where a microadenoma was later found and resected during transsphenoidal surgery. The other three patients, in whom no adenoma was found at surgery, were cured by removal of the half of the gland releasing larger amounts of ACTH. Thus, bilateral simultaneous blood sampling from the inferior petrosal sinuses and a peripheral vein to determine ACTH concentrations consistently predicted the position of the microadenoma in the pituitary gland and allowed surgical cure even in patients with no identifiable adenoma. Furthermore, 7 of 10 patients with microadenomas had ACTH levels in the enferior petrosal sinus contralateral to the adenoma that were the same as peripheral levels of ACTH. If blood had been sampled on this side only, as is common practice, the findings would have suggested an ectopic source of ACTH.

UR - http://www.scopus.com/inward/record.url?scp=0021972654&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0021972654&partnerID=8YFLogxK

M3 - Article

C2 - 2981108

AN - SCOPUS:0021972654

VL - 312

SP - 100

EP - 103

JO - New England Journal of Medicine

JF - New England Journal of Medicine

SN - 0028-4793

IS - 2

ER -