Diagnosis and therapeutic management of Cushing's Syndrome
DOI:
https://doi.org/10.5281/zenodo.14444064Keywords:
Cushing's Syndrome, Diagnosis, Therapy, Surgical treatment, Drug treatment, Endocrine tumorsAbstract
Introduction: Cushing's syndrome (CS) is an endocrine disorder resulting from prolonged exposure to high levels of glucocorticoids, either through exogenous use or excessive endogenous production. Its manifestations vary, including metabolic, cardiovascular, and musculoskeletal complications, making early diagnosis difficult and increasing mortality. Objective: This article reviews recent advances in biochemical diagnosis, tumor localization, and therapeutic modalities for CS, as well as future perspectives for its management. Methodology: An exploratory and qualitative literature review was carried out in the PubMed, SciELO, LILACS, Google Scholar, and MEDLINE databases, considering publications between 2021 and 2023. After initial screening, six articles were analyzed according to the inclusion criteria that directly addressed the diagnosis or treatment of CS. Results and Discussion: Endogenous CS, more frequent in women, often results from ACTH-producing pituitary adenoma. Diagnosis involves confirming hypercortisolism, determining ACTH dependence, and localizing the lesion by imaging tests. Surgical treatment, usually transsphenoidal for pituitary adenomas or adrenalectomy for adrenal tumors, is the first choice. When this is not feasible, drug therapies (steroidogenesis inhibitors, cortisol receptor antagonists), radiotherapy or bilateral adrenalectomy are adopted. New treatments include targeted therapies and molecular imaging techniques, increasing diagnostic accuracy and therapeutic efficacy. Final Considerations: CS is a complex clinical challenge, requiring an individualized approach. Recent advances in diagnosis and therapy offer better control of hypercortisolism, minimizing complications. Continuous research and therapeutic innovations promise to improve the prognosis and quality of life of patients, making treatment safer, more effective and less invasive.
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