Presented as an education exhibit at the 2002 RSNA scientific assembly. Received April 2, 2003; revision requested May 7 and received June 12; accepted June 13. All authors have no financial relationships to disclose. [vrad.com]

These patients usually present at an older age with long standing symptoms. [healio.com]

Six of 10 carcinoma patients had metastases at presentation. Two adenomas were seen within a myelolipoma, which was recognized at both CT and MR imaging due to its fat content, and two adenomas were of uncertain malignant potential. [ncbi.nlm.nih.gov]

We present an uncommon case of ACTH-independent CS in an adolescent girl. Clinical Presentation: The patient was admitted with weight gain. [austinpublishinggroup.com]

Herein we present a case of a woman with Cushing’s syndrome and bilateral adrenal masses. Case presentation A 29-year-old Han Chinese woman was admitted for evaluation of Cushing’s syndrome. [edmcasereports.com]

• Chest Discomfort

  The side effects, which include nausea, vomiting, chest discomfort, headache, dizziness, tachycardia, flushing and abdominal pain, are related to the radiopharmaceutical. [edmcasereports.com]

• Difficulty Climbing Stairs

  - Irregular menses and hirsutism - Progressive proximal muscle weakness, patients may have difficulty climbing stairs, getting out of a low chair, and raising their arms. - Psychological problems (depression, cognitive dysfunction, and emotional lability [aippg.net]

• Rhinorrhea

  Diabetes insipidus, cerebrospinal fluid rhinorrhea, low-grade meningitis, hypothy-roidism, and hypogonadism are the more common complications. Radiation therapy with adjunctive adrenolytic drugs is also an important second- line therapy. [barnardhealth.us]

• Nausea

  The patient reported problems with balance, swelling in her legs, nausea, recurrent rashes and easy bruising. Her psychiatric status made an outpatient evaluation impossible, and she was admitted for further assessment of her adrenal function. [healio.com]

  Adverse effects of ketoconazole include headache, sedation, nausea, irregular menses, decreased libido, impotence, gynecomastia, and elevated liver function tests. The drug is contraindicated during pregnancy. [aippg.net]

  TROMBOSIS BILATERAL ADRENALECTOMY 10 CLINICAL FEATURES IN ADDISON’S DISEASE PRIMARY ADRENOCORTICAL INSUFFICIENCY 1.Hyperpigmentation (=the classic physical finding) of the skin and mucous membranes 2.weakness and fatigue 3.gastrontestinal disturbances: nausea [slideplayer.com]

  Major side effects associated with mitotane include nausea, vomiting, and anorexia. [dermatologyadvisor.com]

• Pruritic Rash

  - Adverse effects of aminoglutethimide include somnolence, headache, a generalized pruritic rash, hypothyroidism, and goiter. In rare cases, it may cause bone marrow suppression. [aippg.net]

• Severe Osteoporosis

  Sometimes asthenic habitus, with short stature, severe osteoporosis, muscle and skin wasting. Near-normal 24-hr UFC, or sometimes cyclical hypercortisolism. [bigtomato.org]

• Nocturia

  Possibilities include polyuria and nocturia from diabetes insipidus. - With severe hypercortisolism, hypokalemic metabolic alkalosis may occur. - Osteoporosis = incident fractures and kyphosis, height loss, and axial skeletal bone pain. [aippg.net]

• Somnolence

  - Adverse effects of aminoglutethimide include somnolence, headache, a generalized pruritic rash, hypothyroidism, and goiter. In rare cases, it may cause bone marrow suppression. [aippg.net]

  Mitotane is a difficult drug to administer: it is given in multiple divided daily doses, and dosage must be carefully titrated to maximize effect and minimize side effects such as diarrhea, vomiting, lethargy, and somnolence. [path.upmc.edu]

• Neglect

  This may occur in patients on steroids who stop taking their glucocorticoids or neglect to increase their steroids during an acute illness. [aippg.net]

[…] ovarian tumors adrenocorticotropin (ACTH)-independent macronodular adrenocortical hyperplasia (AIMAH) : rare cause of ACTH-independent Cushing syndrome 4 corticotropin-releasing hormone-secreting tumor: very rare hypothalamic tumors ectopic production The workup [radiopaedia.org]

Diagnostic workup is necessary perioperatively as well. Usually hydrocortisone 100 mg is given IM or IV preoperatively and q6 hours postoperatively until oral supplements are tolerated. [barnardhealth.us]

Because acute illness activates the HPA axis, resulting in increases in ACTH and cortisol, the laboratory workup for Cushing syndrome should not be performed when subjects are acutely ill. [aippg.net]

[…] hw71687.html ↑ 7.0 7.1 7.2 Gail K Adler, MD, PhD, FAHA, Assistant Professor, Department of Medicine, Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital, Harvard Medical School Cushing Syndrome: Differential Diagnoses & Workup [physio-pedia.com]

Treatment options are summarized in the Table. Treatment Options Treatment options are summarized in the Table 1. Table 1. [dermatologyadvisor.com]

[…] the treatment of ACTH independent adrenal Cushing's Syndrome. [clinicaltrials.gov]

Further treatment depends on the cause: Cushing’s disease – pituitary dependent hyperadrenalism. Trans-sphenoidal removal of the tumour is the treatment of choice. [almostadoctor.co.uk]

These drugs are not usually effective as long-term treatment and are used mainly for preparation for surgery or as adjunctive treatment after surgery or pituitary radiotherapy. [patient.info]

See also Cushing's diagnosis and treatment. [bigtomato.org]

Adrenal carcinoma These are very aggressive and the prognosis is poor. Generally, if there are not widespread metastasis, then you should treat the primary tumour surgically. [almostadoctor.co.uk]

Prognosis is favorable if surgery is curative. The rare adrenocortical carcinomas are associated with a 5-year survival rate of 30% or less. [emedicine.medscape.com]

Treatment and prognosis Management depends on the specific etiology 6. [radiopaedia.org]

[…] children, tumors are usually pheochromocytoma, neuroblastoma, thymic or pancreatic endocrine neoplasm Associated with hypokalemic alkalosis, high urinary excretion of free cortisol, skin pigmentation, edema and severe diabetes mellitus Usually poor prognosis [pathologyoutlines.com]

The prognosis is guardedly favourable with surgery. The rare adrenocortical carcinomas have a five-year survival rate of 30% or less. [patient.info]

Jing-Xia Guo Qiao-Hua Ren Bu-Lang Gao Abstract Purpose: To evaluate the value of carbon dioxide combining power/potassium (CO 2 CP/K) ratio in etiological diagnosis of Cushing’s syndrome. [currentscience.org]

Treatment and prognosis Management depends on the specific etiology 6. [radiopaedia.org]

Recommend a therapeutic regimen for treatment of primary aldosteronism, based on the etiology of the disease in a particular patient. 10. [accesspharmacy.mhmedical.com]

Case Reports: PDF Only Abstract : ACTH-independent Cushing's syndrome secondary to ACTH-independent bilateral macronodular adrenocortical hyperplasia (AIBMAH) is an uncommon disorder, and in most cases the precise etiology has not been determined. [journals.lww.com]

Definition Cushing’s syndrome is a condition which is due to prolonged exposure of the body tissue to excess cortisol (glucocorticoid hormone) Etiology Adrenocorticotropic Hormone (ACTH)-Independent Cushing's Syndrome Endogenous ACTH-Independent Cushing [specialty.mims.com]

Morbidity and mortality in Cushing's disease: an epidemiological approach. Clin Endocrinol (Oxf). 1994;40(4):479-84. [hopkinsguides.com]

Epidemiology Prevalence 5–6/100.000 Most often women in the 3rd and 4th decade of life Causes (Etiology) of Cushing's Syndrome ACTH-dependent Cushing's Syndrome (Overproduction of ACTH): Pituitary adenoma (Cushing's disease) Paraneoplastic ACTH production [urology-textbook.com]

EPIDEMIOLOGY: Cushing syndrome can occur at any age, but usual onset is between 30 and 50 years of age. It is two to three times more common in women than in men. [wikilectures.eu]

Women were 0.3 times less likely to have adverse outcomes in comparison to men. [18] Epidemiology [ edit ] Cases of Cushing's disease are rare, and little epidemiological data is available on the disease. [en.wikipedia.org]

Epidemiology [ 1 ] Incidence of Cushing's syndrome is in the region of 10 to 15 people per million, with a higher incidence in people with diabetes, obesity, hypertension or osteoporosis. [ 4 ] In obese patients with type 2 diabetes, especially those [patient.info]

Understanding Pathophysiology (3rd Ed.). St. Louis, MO: Mosby. Nieman, L.K. (2012). Causes and pathophysiology of Cushing’s syndrome. In A. Lacroix and K.A. Martin (Eds.), UpToDate. [wikilectures.eu]

[…] changes from granular to homogenous, due to accumulation of intermediate filaments Adrenal gland changes: exogenous cortisol causes low ACTH, which causes atrophy of fasciculata and reticularis, not glomerulosa, in residual or opposite adrenal gland Pathophysiology [pathologyoutlines.com]

A recent pathophysiological study showed that cortisol production was regulated by aberrant membrane receptors and by corticotropin produced within the adrenocortical tissue. [ekjm.org]

Etiology Pathophysiology The causes of Cushing’s syndrome are divided into two different groups: ACTH-dependent and ACTH-independent causes. [dermatologyadvisor.com]

Louis: Saunders Elsevier; 2009: 481-483. ↑ 3.0 3.1 3.2 Harold J Bruyere: 100 Case Studies in Pathophysiology. [physio-pedia.com]

To prevent weight gain, aerobic exercise is good to increase your heart rate. Examples of aerobic exercise include fast walking, jogging, cycling, and swimming. [6] Education on avoiding falls and removing loose rugs and other hazards in the home. [physio-pedia.com]

Because glucocorticoids suppress the immune system, they reduce inflammation and are also frequently given to people who have had organ transplants to prevent the immune cells from attacking the transplant. [endocrinediseases.org]

Many cases are not preventable. Cushing syndrome - ectopic; Ectopic ACTH syndrome Nieman LK, Biller BM, Findling JW, et al. Treatment of Cushing's syndrome: an Endocrine Society clinical practice guideline. [medlineplus.gov]

Porphyrias Portal hypertension Postmortem skin changes Postpartum hemorrhage Postpartum period Poststreptococcal glomerulonephritis Precancerous skin lesions Pregnancy Pregnancy loss Prenatal and postnatal physiology Prenatal care Preterm labor and birth Preventive [amboss.com]

Although ACTH levels tend to be higher in ectopic production, there is significant overlap that prevents use of ACTH alone to distinguish between the conditions (2). [path.upmc.edu]