Thesis topics
lnvestigation of the effectiveness of surgical treatment of pituitary microadenomas causing Cushing''s syndrome by intraoperative bilateral petrosus inferior sampling
title
lnvestigation of the effectiveness of surgical treatment of pituitary microadenomas causing Cushing''s syndrome by intraoperative bilateral petrosus inferior sampling
institution
doctoral_school
supervisor
discipline
description
One of the causative factors of hypercorticolism in Cushing''s syndrome is ACTH-dependent, which are primarily triggered by adenohypophyseal or ectopic ACTH-producing adenomas. Due to the small size of these tumors, diagnosis is challenging, but has been improved by the application of the inferior petrosal sinus sampling method. This diagnostic procedure involves catheter-based simultaneous bilateral blood sampling from the inferior petrosal sinuses and the inferior vena cava following CRH or desmopressin stimulation. The measured ACTH serum kinetics highlight the peripheral or central origin of the tumor, and also allow far the localization within the pituitary gland, enabling partial hypophysectomies to be performed. ln the modern neurovascular hybrid operating room of Department of Neurosurgery (Albert Szent-Györgyi Medical School, University of Szeged), developing the method of intraoperative sampling will allow early assessment of surgical outcome.
Additionally, in vitro examination of the surgically obtained adenohypophyseal tissue samples will provide an opportunity to study cellular and epigenetic causal factors, aimed at uncovering the pathogenic mechanisms underlying adenohypophyseal-origin Cushing''s syndromes.
References:
[1]. Howlett TA, Drury PL, Perry L, Doniach 1, Rees LH & Besser GM. Diagnosis and management of ACTH-dependent Cushing''s syndrome: comparison of the features in ectopic and pituitary ACTH production. Clinical Endocrinology 1986 24 699-713.
[2]. Zampetti B, Grossrubatscher E, Ciaramella PD, Boccardi E & Loli P. Bilateral inferior petrosal sinus sampling. Endocrine Connections 2016 S R12-R25.
[3]. Nieman LK, Oldfield EH, Wesley R, Chrousos GP, Loriaux DL & Cutler GB Jr. A simplified morning ovine corticotropinreleasing hormone stimulation test far the differential diagnosis of adrenocorticotropin-dependent Cushing''s syndrome. Journal of Clinical Endocrinology and Metabolism 1993 77 1308-1312.
[4]. Mora M, Putignano P, Lasa M, lnvitti C, Maraschini C & Cavagnini F. The desmopressin test in the differential diagnosis between Cushing''s disease and pseudo-Cushing states. Journal of Clinical Endocrinology and Metabolism 2000 85 3569-3574.
[5]. England RW, Geer EB & Deipolyi AR. Role of venous sampling in the diagnosis of endocrine disorders. Journal of C!inica/ Medicine 2018 7 114.
[6]. Oldfield EH, Chrousos GP, Schulte HM, Schaaf M, McKeever PE, Krudy AG, Cutler GB Jr, Loriaux DL & Doppman JL. Preoperative lateralization of ACTH-secreting pituitary microadenomas by bilateral and simultaneous inferior petrosal venous sinus sampling. New England Journal of Medicine 1985 312 100-103
Additionally, in vitro examination of the surgically obtained adenohypophyseal tissue samples will provide an opportunity to study cellular and epigenetic causal factors, aimed at uncovering the pathogenic mechanisms underlying adenohypophyseal-origin Cushing''s syndromes.
References:
[1]. Howlett TA, Drury PL, Perry L, Doniach 1, Rees LH & Besser GM. Diagnosis and management of ACTH-dependent Cushing''s syndrome: comparison of the features in ectopic and pituitary ACTH production. Clinical Endocrinology 1986 24 699-713.
[2]. Zampetti B, Grossrubatscher E, Ciaramella PD, Boccardi E & Loli P. Bilateral inferior petrosal sinus sampling. Endocrine Connections 2016 S R12-R25.
[3]. Nieman LK, Oldfield EH, Wesley R, Chrousos GP, Loriaux DL & Cutler GB Jr. A simplified morning ovine corticotropinreleasing hormone stimulation test far the differential diagnosis of adrenocorticotropin-dependent Cushing''s syndrome. Journal of Clinical Endocrinology and Metabolism 1993 77 1308-1312.
[4]. Mora M, Putignano P, Lasa M, lnvitti C, Maraschini C & Cavagnini F. The desmopressin test in the differential diagnosis between Cushing''s disease and pseudo-Cushing states. Journal of Clinical Endocrinology and Metabolism 2000 85 3569-3574.
[5]. England RW, Geer EB & Deipolyi AR. Role of venous sampling in the diagnosis of endocrine disorders. Journal of C!inica/ Medicine 2018 7 114.
[6]. Oldfield EH, Chrousos GP, Schulte HM, Schaaf M, McKeever PE, Krudy AG, Cutler GB Jr, Loriaux DL & Doppman JL. Preoperative lateralization of ACTH-secreting pituitary microadenomas by bilateral and simultaneous inferior petrosal venous sinus sampling. New England Journal of Medicine 1985 312 100-103
student count limit
2
location
University of Szeged, Albert Szent-Györgyi Medical School, Department of Neurosurgery
deadline
2026-08-31