TY - JOUR T1 - NElson's syndrome and spontaneous pituitary tumor infarction AU - Jordan RM, Cook DM, Kendall JW, Kerber CW Y1 - 1979/03/01 N1 - 10.1001/archinte.1979.03630400056021 JO - Archives of Internal Medicine SP - 340 EP - 342 VL - 139 IS - 3 N2 - Large, adrenocorticotrophic hormone-secreting pituitary tumors (Nelson's syndrome) developed in four of 12 patients treated with a bilateral adrenalectomy for Cushing's disease. Two of the patients with Nelson's syndrome suffered spontaneous pituitary tumor infarctions. One patient improved under close observation and subsequent radiation therapy, although she ultimately died from her locally invasive tumor. The condition of the other patient—which had stabilized—appeared to be worsened by surgical intervention. The high incidence of these tumors after bilateral adrenalectomy, their large and aggressive nature, and their apparent propensity to undergo spontaneous infarction supports the position that initial therapy for Cushing's disease should be directed to the pituitary gland.(Arch Intern Med 139:340-342, 1979) SN - 0003-9926 M3 - doi: 10.1001/archinte.1979.03630400056021 UR - http://dx.doi.org/10.1001/archinte.1979.03630400056021 ER -