A Comprehensive Overview of Removal Methods for the Surgical Treatment of Cushing's Disease for Human and Veterinary Applications

摘要

Over the last few decades the prevalence of equine Cushing's disease has been increasing. Surgical treatment of this disease, which entails the removal of the pituitary (pars intermedia) adenoma located within the sella turcica of the skull (a saddle-shaped depression in the sphenoid bone), can be performed on humans. Yet, due to anatomical constraints, the same procedure is not applicable to horses. As a result, the only available treatment modality to date is oral medication, which most horse owners are unable to afford. Additionally, oral medication only offers a temporary solution to the disease, with varying outcomes [1]. New ways to surgically treat equine Cushing's disease is a necessity to provide a more cost effective treatment for the horse owners. Furthermore, insight into new treatment modalities to halt disease progression and potentially aid in surgical treatment are warranted from a comparative medicine perspective. Additionally, better understanding of equine Cushing's disease could provide insight into new treatment modalities for human Cushing's disease as well as potentially help unravel the early initiating event in the disease development. The aim of the current study was to provide a comprehensive overview of potential removal methods for the surgical treatment of Cushing's disease in both horses and humans.