What is the primary treatment option that shows remission in 60-80% of Cushing's cases?

Surgery is considered the primary treatment option for Cushing's syndrome, particularly when the condition is caused by a pituitary adenoma, which is the most common cause of endogenous Cushing's disease. The goal of surgical treatment is to remove the tumor or the adrenal gland causing excessive cortisol production. Studies have shown that surgical intervention can lead to remission in a significant proportion of patients, with rates reported between 60-80%.

This effectiveness is primarily due to the ability of surgical procedures, such as transsphenoidal resection for pituitary adenomas, to directly address the source of cortisol overproduction. The outcome depends on various factors, including the size of the tumor, the duration of the disease, and the overall health of the patient. Successful surgery can lead to a resolution of symptoms and restore normal cortisol levels, therefore achieving the primary goal of treatment.

While other options such as radiation therapy and medication management are used for managing Cushing's syndrome, they do not offer the same remission rates as surgery, particularly in cases where surgery is feasible. Hormonal therapy can help manage specific symptoms but is not a primary treatment for curing the condition.