Cushing's disease in Western Norway Regional Health Authority.
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BACKGROUND: Cushing's disease is caused by a pituitary adenoma that produces adrenocorticotropic hormone (ACTH), leading to overproduction of cortisol by the adrenal glands. The aim of the study was to investigate the incidence, clinical manifestation and treatment outcomes in Western Norway Regional Health Authority. MATERIAL AND METHOD: The study is based on a retrospective review of medical records of patients diagnosed with Cushing's disease at Haukeland University Hospital in Bergen during the period 1 January 2010 to 31 December 2022. RESULTS: We identified 42 patients with Cushing's disease during the period 1 January 2010 to 31 December 2022. The incidence was estimated at 3.0 per million inhabitants per year. Thirty-three of the 42 patients had one or more metabolic disorders at the time of diagnosis. All underwent transsphenoidal pituitary surgery. Twenty-five of the 42 patients went into remission after the first or second operation. At the end of the study or at the time of death, 20 patients were in remission following pituitary surgery and/or Gamma Knife radiotherapy: 2 out of 7 with macroadenoma, 12 out of 21 with microadenoma, and 6 out of 14 with no conclusive findings from magnetic resonance imaging (MRI). Of the remaining 22 patients, 5 underwent bilateral adrenalectomy, while 13 had persistent disease at the end of the study or at the time of death. Long-term outcome data were missing for two patients, and two had recently undergone surgery with results still pending. INTERPRETATION: The incidence of Cushing's disease in Western Norway Regional Health Authority is higher than that reported in previous European studies. Treatment outcomes were associated with tumour characteristics, which highlights the need to tailor treatment strategies to the individual patient.