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OCR: treatment Transsphenoidal surgery has become the ist centres, of choice for Cushing's disease, In specia remission rates following transsphenoid ing hypophysectomy of eighty per cent are b IT achieved, Immediate postoperative ACT 1 levels) is insufficiency (undetectable serum cortis of the ciency of a valuable marker of successful removal pituitary lesion. This isolated ACTH defi take the pituitary is usually transient but may e cortisol months or years to remit. If postoperativ and underlevels are lower than preoperative level patient's 300nmol/l but not below 50nmol/l, the patient condition will be improved although th will probably not be cured,