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Context: Prevalence of Cushing's syndrome (CS) in patients presenting with hirsutism is not well known. Objective: Screening of CS in patients with hirsutism. Setting: Referral hospital. Patients and other participants: This study was carried out on 105 patients who were admitted to the Endocrinology Department with the complaint of hirsutism. Intervention: All the patients were evaluated with low-dose dexamethasone suppression test (LDDST) for CS. Main outcome measure: Response to LDDST in patients presenting with hirsutism. Results: All the patients had suppressed cortisol levels following low-dose dexamethasone administration excluding CS. The etiology of hirsutism was polycystic ovary syndrome in 79%, idiopathic hirsutism in 13%, idiopathic hyperandrogenemia in 6%, and nonclassical congenital hyperplasia in 2% of the patients. Conclusion: Routine screening for CS in patients with a referral diagnosis of hirsutism is not required. For the time being, diagnostic tests for CS in hirsute patients should be limited to patients who have accompanying clinical stigmata of hypercortisolism.

Cushing's syndrome (CS) may lead to severe maternal and fetal morbidities and even mortalities in pregnancy. However, pregnancy complicates the diagnosis and treatment of CS. This study describes a 26-year-old pregnant woman admitted with hypertension-induced headache. Hormonal analyses performed due to her cushingoid phenotype revealed a diagnosis of adrenocorticotropic hormone- (ACTH-) independent CS. MRI showed a 3.5 cm adenoma in her right adrenal gland. After preoperative metyrapone therapy, she underwent a successful unilateral laparoscopic adrenalectomy at 14-week gestation. Although she had a temporary postoperative adrenal insufficiency, hormonal analyses showed that she has been in remission since delivery. Findings in this patient, as well as those in previous patients, indicate that pregnancy is not an absolute contraindication for laparoscopic adrenalectomy. Rather, such surgery should be considered a safe and efficient treatment method for pregnant women with cortisol-secreting adrenal adenomas.

GirişAkciğer kanseri tüm dünyada olduğu gibi yurdumuzda da en sık görülen kanser çeşidi olup vakaların %90'ında etiyolojide sigara bulunmaktadır. Sigara tüm akciğer kanser alt tiplerinde etiyolojide yer almakla birlikte en güçlü ilişki küçük hücreli ve skuamöz hücreli akciğer kanserlerinde izlenmektedir (1). Yalnız akciğer kanserlerine spesifik olarak kabul edilebilecek herhangi bir belirti bulunmamakta birlikte hastaların çoğunda öksürük, balgam, hemoptizi ve nefes darlığı görülmektedir. Diğer taraftan halsizlik, iştahsızlık ve kilo kaybı gibi sistemik belirtiler de görülebilmektedir (2). Alt tiplere göre değişkenlik göstermekle birlikte akciğer kanserleri özellikle tanıda gecikilen vakalarda sıklıkla metastatiktir. Bu bağlamda hastalarda metastazlara bağlı belirtilerle de karşılaşılabilmektedir. Lokal metastazlar dışında kemik, karaciğer ve beyin en sık metastaz yaptıkları organlardır (3).