Laparoscopic Bilateral Adrenalectomy in a Patient of Cushing Disease due to Pituitary Microadenoma: a Challenge for the Anaesthesiologist

Abstract

Cushing’s syndrome has a multi-factorial aetiology. Administration of exogenous steroids in oral formulations, injected or inhaled forms can cause development of Cushing’s syndrome. Endogenous causes may be ACTH dependent (80% of the cases) or independent (20% of the cases). ACTH overproduction may be of pituitary origin (85% cases) or result from ectopic tumor secretion (15% cases). The term Cushing’s disease is specifically applied to ACTH-secreting pituitary tumors. ACTH independent causes are mainly due to benign (60%) or malignant (40%) adrenal tumors. Several studies have shown the association of Cushing’s Syndrome with pheochromocytoma