What is a treatment option for Cushings disease?

• A. Adrenalectomy
• B. Splenectomy
• C. Thyroidectomy
• D. Nephrectomy

Answer: (A)

Treating Cushings disease centers on lowering the excess cortisol produced by the body. Adrenalectomy directly achieves this by removing the adrenal glands, the organs that actually produce cortisol. This option is considered when pituitary-directed therapy isn’t possible, hasn’t controlled the disease, or in very severe cases where rapid cortisol reduction is needed. By taking out the adrenals, cortisol levels drop quickly, but the body then can’t make its own steroids, so lifelong hormone replacement therapy is required to replace cortisol (and often aldosterone) and keep salts and blood pressure in balance. There’s also a risk that the pituitary will react by increasing ACTH production, which can lead to Nelson’s syndrome if the pituitary tumor isn’t managed. The other procedures don’t address cortisol production at all, so they aren’t appropriate treatments for Cushings disease in this context.