Cushing Syndrome: Presentation, Diagnosis, and Treatment, Including Subclinical Cushing Syndrome

Simultaneous pituitary and adrenal adenomas in a patient with non ACTH dependent Cushing syndrome; a case report with literature review

“…The classical symptoms of CS include weight gain, hirsutism, striae, plethora, hypertension, ecchymosis, lethargy, menstrual irregularities, diminished libido, and proximal myopathy [16] . Neurobehavioral presentations include anxiety, sadness, mood swings, and memory loss [17] . Less commonly presented features include headaches, acne, edema, abdominal pain, backache, recurrent infection, female baldness, dorsal fat pad, frank diabetes, electrocardiographic abnormalities suggestive of cardiac hypertrophy, osteoporotic fractures, and cardiovascular disease from accelerated atherosclerosis [10] .…”

“…Surgical resection of the origin of the ACTH or glucocorticoid excess (pituitary adenoma, nonpituitary tumor-secreting ACTH, or adrenal tumor) is still the first-line treatment of all forms of CS because it leaves normal adjacent structures and results in prompt remission and inevitable recovery of regular adrenal function [12] , [25] . Laparoscopic (retroperitoneal or transperitoneal) adrenalectomy has become the gold standard technique for adrenal adenomas since it is associated with fewer postoperative morbidity, hospitalization, and expense when compared to open adrenalectomy [17] . In refractory cases, or when a patient is not a good candidate for surgery, cortisol-lowering medication may be employed [26] .…”

Acute pancreatitis associated with Cushing syndrome – A case report and literature review

“…The 24-hour urinary cortisol assay detect endogenous overproduction of cortisol. Cushing's syndrome is confirmed when result is more than four times the normal [ 6 ]. Measurement of plasma ACTH levels helps to differentiate ACTH-dependent CS from ACTH-independent CS.…”