To the Editor: Styne et al. present convincing data to support transsphenoidal pituitary surgery by an experienced neurosurgcon as the initial treatment for childhood and adolescent Cushing's disease (April.5) issue).1 In Hardy's series of 75 cases treated with such surgery, 20 patients were under 20 years old.2 No doubt transsphenoidal pituitary surgery offers advantages over bilateral adrenalectomy or pituitary irradiation as the initial treatment. The question of recurrent hypercortisolism after surgery still lingers. Cushing's disease recurred after transsphenoidal pituitary surgery in only 1 of the 15 patients of Styne et al. Yet, the same surgeon (Dr. Wilson), in a review.
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