A case of Cushing's disease presenting with avascular necrosis of the femoral heads is described. Eighteen months after the onset of hip symptoms the patient developed pituitary apoplexy and presented to hospital as a medical emergency. Endogenous hypercortisolism is a rare and important cause of avascular necrosis of bone.

Although subclinical Cushing's syndrome has been commonly experienced, details of the clinical outcome and its indication for adrenalectomy have yet to be established. In the present study, we investigated the prevalence of cardiovascular risks, their clinical outcome during long-term follow up before and after adrenalectomy in 20 patients with subclinical Cushing's syndrome. We also correlated...

The relationship among obesity, impaired glucose tolerance or diabetes, hypertension, and gonadal dysfunction was initially recognized in two clinical syndromes described early in the 20th century. In 1932, Harvey Cushing reported these findings as well as other features of endogenous hypercortisolism in patients with small basophilic pituitary adenomas (1). A decade earlier, two French physici...

UNLABELLED A 45-year-old female was referred for endocrine evaluation of an incidental mass (31×24 mm in diameter) on the right adrenal gland. The patient was normotensive and nondiabetic, and had no history of generalised obesity (body weight, 46 kg at 20 years of age and 51.2 kg on admission); however, her waist-to-hip ratio was 0.97. Elevated urinary free cortisol levels (112-118 μg/day) and...

Cushing syndrome due to the administration of pharmacologic doses of glucocorticoids is common, whereas hypercortisolism from an adrenal mass is quite rare. Adrenal masses are incidentally detected with a prevalence ranging from 8.7–12.4%, and most of these lesions are hormonally inactive. In this article, we describe a unique patient with a glucocorticoid-producing adrenal mass who was diagnos...

OBJECTIVE Primary pigmented nodular adrenocortical disease (PPNAD), an uncommon cause of Cushing's syndrome, is frequently associated with a wider clinical spectrum, the Carney complex (CC), a multiple endocrine neoplasia syndrome. DESIGN We evaluated a low-dose mitotane regimen for treating severe hypercortisolism in a 27-year-old woman with CC. She presented with severe hypercortisolism and...

SUMMARY Cushing's syndrome is associated with increased morbidity and mortality. Although surgery is the first-line treatment, drugs can still play a role as an ancillary treatment to be employed while waiting for surgery, after unsuccessful operation or in patients unsuitable for surgery. We were asked to evaluate a 32-year-old male waiting for cardiac transplantation. Idiopathic hypokinetic c...

This case shows efficacy of low-dose pasireotide in biochemical and clinical control of severe hypercortisolism and in tumor volume reduction in a patient with an ACTH-secreting macroadenoma. The drug may be an option for long-term treatment in some patients where control of tumor mass is an important clinical endpoint.