Cushing's Disease: Dilemmas of Diagnosis and Management

Authors

M. Saeed-uz-Zafar
Raymond C. Mellinger
Max WisgerhofFollow

Abstract

Determining the cause of Cushing's disease and correcting the abnormality presents a continuing challenge to the clinician despite remarkable advances in diagnostic and therapeutic techniques. We present seven cases to illustrate 1) the classic disorder cured by pituitary adenomectomy: 2) persistence of the disease after adenomectomy: 3) Cushing's disease manifesting in the puerperium and remitting with dopamine agonist therapy: 4) a patient whose disease relapsed at least five times during 20 years of treatment by adrenalectomy, pituitary radiation, mitotane, and pituitary adenomectomy; 5) the Nelson syndrome; 6) the ectopic adrenocorticotropic hormone (ACTH) syndrome in a patient with dexamethasone suppressible urinary cortisol who had a pituitary adenoma which stained positively for ACTH hut who was not cured by total hypophysectomy; and 7) a patient whose ACTH-secreting tumor proved fatal despite repeated surgical, radiologic, and pharmacologic measures.

Recommended Citation

Saeed-uz-Zafar, M.; Mellinger, Raymond C.; and Wisgerhof, Max (1991) "Cushing's Disease: Dilemmas of Diagnosis and Management," Henry Ford Hospital Medical Journal : Vol. 39 : No. 1 , 10-17.
Available at: https://scholarlycommons.henryford.com/hfhmedjournal/vol39/iss1/3