Therapeutic and prognosis of Cushing's syndrome: A multicenter retrospective study

Cushing's syndrome (CS) is a complex pathology associated with heavy mortality and morbidity. Its management includes medical-treatment of comorbidities and tumor removal if possible. Long-term follow-up is highly recommended given the evolving risk of comorbidities, even after remission, as well as the risk of persistence of the disease or relapse. A multicenter retrospective study including all patients with confirmed endogenous CS and followed in the Endocrinology & Diabetology departments of Monastir and Sousse hospitals between January 1989 and December 2021. In all, 76% of patients with ACTH-dependent CS had a first-line transsphenoidal pituitary surgery with complete (89.3%) or partial (10.7%) resection. Some patients developed postoperative complications such as diabetes insipidus (34.28%), which was temporary in28.57% of cases and definitive in 5.71% of cases, meningitis (2.85%), osteomeningeal breach with cerebrospinal fluid rhinorrhea (5.71%), sphenoidal sinusitis (5.71%). Remission was detected in 70.4% of cases, persistance in25.92% and recurrence in3.7% within 6years. In literature, remission was noted in 70% to 80% of patients who underwent pituitary-surgery with recurrence in15%to25%of cases depending on studies and follow-upduration [1] . Diabetes-insipidus was also the most common postoperativecomplication (23%) reported in the study of Sudhakar and al. [2] .