NELSON'S SYNDROME: PATHOPHYSIOLOGY, DIAGNOSIS, AND MANAGEMENT STRATEGIES

 
Abstract: Nelson’s Syndrome (NS) is a rare but serious complication arising 
after bilateral adrenalectomy (BA) in patients with Cushing’s disease. The progressive 
enlargement  of  a  pituitary  adenoma  and  excessive  secretion  of  adrenocorticotropic 
hormone  (ACTH),  which  can  lead  to  hyperpigmentation,  visual  disturbances,  and 
potentially life-threatening complications characterize this condition. Despite advances 
in endocrine surgery and pituitary imaging, NS remains a diagnostic and therapeutic 
challenge. This article reviews the current understanding of the pathophysiology of NS, 
presents  clinical  findings  from  recent  studies,  evaluates  diagnostic  criteria,  and 
discusses treatment options including surgery, radiotherapy, and medical therapy. The 
study also proposes recommendations for early detection and prevention strategies to 
minimize the development of NS post-adrenalectomy.