[ XXXX in the 90's: a review].

@entity1 @entity4545 @entity5 @entity699 @entity652
Since 1932 when @entity699 has been described, several important advances have been made in diagnosis and management. However several points remain obscure and there is no general agreement among authors. An accurate biological diagnosis is one of the difficulties found when we face a @entity1 with @entity699 . In addition, corticotropin dependent syndrome should be distinguished from the independent one, as well as identifying the source of @entity4545 hypersecretion. The main problem in @entity699 is to localise the secreting @entity652 and at the moment there is not any diagnostic method with absolute sensibility and specificity. Magnetic Resonance Imaging shows a sensibility of 77% and 87% especificity; inferior petrosal sinus sampling may help in localising the side, where the @entity652 lies, although an appropriate technique is mandatory. New developing techniques, such as intraoperative doppler and assessment of @entity4545 levels in the peripituitary veins may help us in localising the source of @entity4545 hypersecretion. Sometimes the @entity652 cannot be identified and a surgical exploration of the pituitary is required. If an @entity652 is found, a 89% probility of curation has been reported; on the contrary, incomplete @entity5 removal, no @entity5 found at surgery, or the presence of the so-called corticotrop hyperplasia where followed of bad results and may explain the failed surgery. Then, hypofisectomy, hemi-hypofisectomy, radiotherapy, photon knife or gamma knife, may be of help in the control of this condition. We reviewed the recent literature and analysed the diagnostic strategies and teatments currently available for this illness. In addition we propose an algohritm for diagnosis and treatment and analyze our results in a consecutive series of 38 @entity1 .
