Original ArticlesDiagnosis, Perioperative Care, and Remission in Cushing DiseaseThomas, Ajith J. MD*; Prevedello, Daniel M. MD*; Tomycz, Nestor D. MD*; Gardner, Paul MD*; Challinor, Susan MD†; Mintz, Arlan MD†; Horowitz, Michael B. MD*; Kassam, Amin MD*Author Information Departments of *Neurosurgery †Endocrinology, University of Pittsburgh School of Medicine, Pittsburgh, PA Reprints: Amin Kassam, MD, Department of Neurosurgery, University of Pittsburgh Medical Center, 200 Lothrop Street, Suite B 400, Pittsburgh, PA 15213 (e-mail: email@example.com). Neurosurgery Quarterly: September 2008 - Volume 18 - Issue 3 - p 153-158 doi: 10.1097/WNQ.0b013e318173001b Buy Metrics Abstract Cushing disease (CD) is hypercortisolemia caused by a pituitary tumor. The culprit sellar neoplasm is often too small to detect on neuroimaging, yet its size belies its immense potential morbidity. Modern care of these complex patients demands a dedicated team composed of neurosurgeons, otolaryngologists, and endocrinologists to navigate patients toward a cure. Diagnosis alone is a challenge as CD shares a similar phenotype of cortisol excess with several other disorders that can cause Cushing syndrome. Operative techniques and nuances aside, we summarize the pertinent endocrinologic foundation a neurosurgeon should possess to manage CD. © 2008 Lippincott Williams & Wilkins, Inc.