Cushing 病に対する Gamma Knife Radiosurgeryの有効性

Two cases with recurrent pituitary dependent Cushing's disease after transsphenoidal surgery were treated with gamma knife using stereotactic MRI. Microadenomas of these two cases were visualized as hypointense area by gadolinium-enhanced MRI. The doses given to the margin of the tumors were 20Gy and 35Gy at each case. The doses given to optic system and cranial nerves in the cavernous sinus were less than 8Gy and 20Gy respectively. Both of the patients had clinical remission and with normal serum cortisol and ACTH levels two years after gamma knife surgery. Neither of the patients developed insufficient secretion of any pituitary hormone nor neurological deterioration. In conclusion,gamma knife surgery for Cushing's disease may be effective when pituitary adenomas can be visualized clearly by MRI.journal articl