PURPOSE: Nelson's syndrome is a severe complication of bilateral adrenalectomy 
performed in the treatment of some Cushing's diseases, and its management 
remains difficult. Trough the observation of a patient suffering from a severe 
form of Nelson's syndrome for more than 10 years, the authors review the 
literature and discuss the main current therapeutic possibilities.
CURRENT KNOWLEDGE AND KEY POINTS: Many molecules have been used with variable 
results. In our observation cabergoline at 2 mg per week seems to be efficient 
after a 3 and a half years follow-up, in accordance with some recent 
publications. More than bromocriptine, this dopamine agonist provides 
interesting prospects for this disease's management. Moreover, if the 
conventional treatments as valproic acid or cyproheptadine are not very 
efficient, somatostatin analogs seem to be of some therapeutic interest.
FUTURE PROSPECTS AND PROJECTS: New molecules are currently evaluated, but 
studies are difficult to conduct because of the low disease prevalence. Tumour 
receptors analysis undoubtedly constitutes an attractive way to find new 
therapeutic targets.