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At least 163 records · Page 9Linked to original sources
PubMed1985

Cushing's syndrome.

Cushing's syndrome remains one of the most challenging problems in clinical endocrinology. Cushing's disease is caused in the majority of cases by basophil pituitary microadenomas which may be successfully treated by trans-sphenoidal hypophysectomy. Treatment with metyrapone or o,p'-DDD can always induce a clinical remission but not a cure, and neurotransmitter therapy may be effective in a minority of cases. Pituitary irradiation cures about half of cases in the long-term and may be used for surgical failures. Tumours producing ectopic ACTH are frequently benign, small and occult and may produce a syndrome clinically indistinguishable from Cushing's disease. Biochemical investigations cannot absolutely distinguish pituitary from ectopic sources of ACTH and therefore body CT scanning and percatheter venous sampling are essential diagnostic investigations. Tumour localization may result in resection and complete cure, although even small tumours may have a malignant potential. Adrenal tumours are readily diagnosed by plasma ACTH measurement and adrenal CT scanning. Adrenal adenomas are cured by adrenalectomy. Carcinomas may be treated by a combination of adrenalectomy, radiotherapy and o,p'-DDD, but long-term prognosis is poor.

Adrenal Cortex Hormones↗
PubMed1992

[Cushing syndrome in a neuroendocrine pancreatic tumor. Clinicopathologic case report].

A 59-year-old female patient with mild clinical features of a Cushing syndrome underwent surgery for a suspected hormonally active tumor of the left adrenal gland. Surprisingly, the adrenal gland was unremarkable, however, a tumor in the pancreatic tail was found. A left pancreatic resection with splenectomy resulted in curative removal of the tumor. The pathohistological examination of the tumor established the diagnosis of an ACTH-producing pancreatic carcinoid. Morphology and pathogenesis of pancreatic carcinoids which are tumors of the APUD-cell-system are discussed in detail.

ACTH Syndrome, Ectopic↗
PubMed1996

Adrenalectomy for treatment of Cushing syndrome: results in 122 patients and long-term follow-up studies.

Patients with Cushing syndrome (n = 122) who underwent adrenalectomy from 1957 through 1993 were reviewed for survival and complications. Of the 122 patients, 70 had adrenocortical adenoma, 30 Cushing's disease, 6 primary pigmented nodular adrenocortical disease (PPNAD), 7 other types of primary nodular hyperplasia, 5 adrenocortical carcinoma, and 4 ectopic ACTH syndrome. Sixty-five patients with adrenocortical adenoma are alive, and the survival rate was equal to the age-matched control population, when patients who died of the postoperative complication were excluded. Of the patients with Cushing's disease, 20 are alive; and 10 of 16 patients (63%) who were followed-up and evaluated had skin pigmentation. Four of sixteen patients (25%) developed Nelson's syndrome. Four PPNAD patients and five with other types of nodular hyperplasia are alive. Most of these patients underwent bilateral total adrenalectomy, but some patients remitted after unilateral adrenalectomy. All of five adrenocortical carcinoma patients and four with ectopic ACTH syndrome died within 2 years after operation. The prognosis for patients with adrenocortical adenoma after unilateral adrenalectomy is excellent, though it is important to avoid operative complications. The rapid cure of signs and symptoms of glucocorticoid excess after total adrenalectomy is ensured, and prognosis is satisfactory under careful glucocorticoid replacement, making total adrenalectomy an alternative treatment for Cushing's disease.

ACTH Syndrome, Ectopic↗
PubMed2000

[Clinical analysis of glucose dysbolism in 162 cases with Cushing syndrome].

OBJECTIVE: To understand the characteristic of steroid diabetes by the analysis for clinical data of 162 cases with Cushing syndrome (CS) proved by pathological report. METHODS: Retrospective analysis for the data of CS about age of CS onset, duration of CS, body mass index (BMI), 24 hours urine free cortisol (24 h UFC), pathological report, fasting blood glucose (FBG) pre- and post-operation, family history of diabetes, treatment of glucose dysbolism (GD) pre- and post-operation. RESULTS: The onset age and duration of CS in GD group was obviously earlier and longer than normal glucose (NG) group. BMI and 24 h UFC were no difference between two groups. Besides adrenal adenocarcinoma, no difference was found in types of pathology. FBG of diabetes pre-operation was obviously lower than post-operation. After operation, most diabetes need not on drug treatment. Only one secondary diabetes has family history. CONCLUSIONS: Steroid diabetes easily occurs in patients who is senility and suffer longer course of CS. No relation to diabetic family history, concentric obesity, the level of UFC and benign types of pathology. Therapeutical emphasis of steroid diabetes is radical cure of CS.

Adolescent↗
PubMed1995

[Informative value of various diagnostic methods in Itsenko-Cushing syndrome].

The authors discuss the comparative evaluation of different methods of examination applied in 36 patients with the Icenko-Cushing syndrome. The results of the investigation are compared with the intraoperative findings and the data of morphological studies. MR-topography proved to be mist informative. Ultrasonic examination was highly effective in tumors measuring up to 1 cm in diameter. The use of USE during the operation hor locatind the tumor and determining its connection with the surrounding organs allows the operation to be performed in a shorter time and its traumatic character.

Adrenal Gland Neoplasms↗
PubMed1988

[Cushing syndrome--a leading symptom in bronchial carcinoid].

Bilateral adrenalectomy was performed in a 27-year-old male because of Cushing's syndrome. After 7 years a peripheral bronchial carcinoid was diagnosed; ACTH values went back to normal only after removal of the carcinoid. In the literature, there are 31 case reports on bronchial carcinoids associated with Cushing's syndrome. The Cushing's syndrome precedes the diagnosis of a tumor for months to years in at least half of the cases. Most of these patients first underwent adrenalectomy and/or hypophysectomy for their primarily endocrine symptoms and signs.

ACTH Syndrome, Ectopic↗
PubMed2006

Cushing's syndrome.

Cushing's syndrome results from lengthy and inappropriate exposure to excessive glucocorticoids. Untreated, it has significant morbidity and mortality. The syndrome remains a challenge to diagnose and manage. Here, we review the current understanding of pathogenesis, clinical features, diagnostic, and differential diagnostic approaches. We provide diagnostic algorithms and recommendations for management.

Adrenocorticotropic Hormone↗