Nelson’s syndrome: an update

Research output: Contribution to journalArticlepeer-review


Colleges, School and Institutes


Nelson's syndrome (NS) is a condition which may develop in patients with Cushing's disease after bilateral adrenalectomy. Although there is no formal consensus on what defines NS, corticotroph tumor growth and/or gradually increasing ACTH levels are important diagnostic elements. Pathogenesis is unclear and well-established predictive factors are lacking; high ACTH during the first year after bilateral adrenalectomy is the most consistently reported predictive parameter. Management is individualized and includes surgery, with or without radiotherapy, radiotherapy alone, and observation; medical treatments have shown inconsistent results. A subset of tumors demonstrates aggressive behavior with challenging management, malignant transformation and poor prognosis.


Original languageEnglish
Pages (from-to)413-432
Number of pages20
JournalEndocrinology and Metabolism Clinics of North America
Issue number3
Early online date30 Jul 2020
Publication statusPublished - Sep 2020


  • Bilateral adrenalectomy, Corticotroph tumor progression, Cushing's, Nelson's syndrome, Tumor growth