From the year 1989 to December 1994, 59 patients with Cushing syndrome (12 males, 47 females aged 15-46) were investigated. Clinical symptoms: central obesis, round face, weakness, high blood pressure, cracked skin, mental disorder, acnea, hirsulism. Laboratory examinations: high level of urine 17OHCS, cortisol secretion increasing in 8 and 20 o’clock and loss of secretion. Morphological examinations: X-ray radiography of hypophysal hole, ultrasound of surrenal gland, CT scan of hypophysal hole. Causes: 79.7% is Cushing disease, 11.8% adenoma od surrenal gland, 8.5% surrenal cancer
Cushing Syndrome ; diagnosis ; epidemiology

No abstract available.
Cushing Syndrome* ; Diagnosis* ; Diagnosis, Differential*

Neuroendocrine tumors of the gallbladder are rare, and typically found incidentally after a cholecystectomy. Few data are available on adrenocorticotrophic hormone (ACTH)-producing neuroendocrine tumors originating specifically from the gallbladder. We experienced the case of a patient with a gallbladder mass who presented with Cushing's syndrome, who was subsequently diagnosed as an ACTH-producing neuroendocrine carcinoma of the gallbladder. Despite being rare, hormone-producing neuroendocrine tumors should be part of the differential diagnosis in patients with Cushing's syndrome.
ACTH Syndrome, Ectopic ; Adrenocorticotropic Hormone ; Carcinoma, Neuroendocrine* ; Cholecystectomy ; Cushing Syndrome* ; Diagnosis, Differential ; Gallbladder* ; Humans ; Neuroendocrine Tumors

A 28-year old female was diagnosed preoperatively to have a pheochromocytoma producing ACTH at other hospital. However the operation was delayed due to poor general condition and abnormal liver function. She revealed severe hypercortisolism, hypokalemic metabolic alkalosis, glucose intolerance and showed rapid downhill course. She was transferred to our hospital for operation but septic complications were strarted already. She was not recovered in spite of desperate operation and died just after moribund discharge. ACTH producing pheochromocytoma is uncommon and literature review indicated high mortality rates due to improper preoperative diagnosis. Proper preoperative recognition and early surgical management is mandatory for better results.
ACTH Syndrome, Ectopic* ; Adrenocorticotropic Hormone ; Alkalosis ; Cushing Syndrome ; Diagnosis ; Female ; Glucose Intolerance ; Humans ; Liver ; Mortality ; Pheochromocytoma*

Between 1980 and 1989, our experience of surgical management with 21 adrenal diseases was presented. There were 3 cases of Cushing's syndrome, 3 of primary aldosteronism, 6 of pheochromo cytoma, 5 of neuroblastoma, 2 of extraadrenal paraganglioma, 1 of adrenocortical carcinoma and 1 of adrenal cyst. The use of advanced radiographic and laboratory procedures resulted in the refinement of diagnosis and localization of tumors, enabling better surgical management of adrenal disorders. Among those, 19 cases underwent unilateral adrenalectomy and 2 cases of Cushing's disease underwent bilateral adrenalectomy. Surgical approaches to the adrenal gland were transperitoneal in 16 cases and extraperitoneal in 5 cases. Operative complications occurred in 11 cases. The incidence, however, of complications related to the operative approach was not significant except in 2 cases of postoperative ileus.
Adrenal Glands ; Adrenalectomy ; Adrenocortical Carcinoma ; Cushing Syndrome ; Diagnosis ; Hyperaldosteronism ; Ileus ; Incidence ; Neuroblastoma ; Paraganglioma

Cryptococcosis is a disease caused by Cryptococcus neoformans, that most commonly affects immunosuppressed patients. Cutaneous cyptococcosis occurs in 10-15% of disseminated cases and its clinical manifestation is variable. We have presented an unusual manifestation of cutaneous cryptococcosis in a patient with iatrogenic Cushing syndrome. Clinically, the ulcers were considered to be pyoderma gangrenosum but the tissue biopsy and culture revealed cryptococcosis. This case illustrates that in making the diagnosis of pyoderma gangrenosum, one must exclude deep fungal infection.
Biopsy ; Cryptococcosis* ; Cryptococcus neoformans ; Cushing Syndrome ; Diagnosis ; Humans ; Pyoderma Gangrenosum* ; Pyoderma* ; Ulcer

Diagnostic accuracy in localizing tumors by means of computed tomography (CT), adrenal scintigraphy, ultrasonography (US) and IVP was compared in 12 cases of adrenal tumors which were experienced during last 6 years. The following results were obtained : 1. The patient group consists of 8 pheochromocytomas, 3 primary aldosteronism, and 1 Cushing syndrome. 2. For the initial diagnosis of adrenal cortical tumor (primary aldosteronism, Cushing syndrome) CT and adrenal scintigraphy are reliable and noninvasive modalities with high diagnostic accuracy, whereas in pheochromocytoma, US, CT and adrenal scintigraphy was useful. 3. Invasive diagnostic modalities such as aortography, venous sampling of adrenal gland and venography should be restricted to localizing adrenal tumors cannot be diagnosed by previous non -invasive diagnostic modalities.
Adrenal Glands ; Aortography ; Cushing Syndrome ; Diagnosis ; Humans ; Hyperaldosteronism ; Pheochromocytoma ; Phlebography ; Radionuclide Imaging ; Ultrasonography

PURPOSE: To examine and compare the perioperative outcomes of laparoscopic adrenalectomy (LA) and to determine its efficacy in patients with nonfunctioning adrenal adenomas (NFA) and subclinical Cushing syndrome (SCS). MATERIALS AND METHODS: We retrospectively analyzed the clinical data obtained from 79 consecutive patients who underwent LA for the treatment of either NFA (n=35) or SCS (n=44) between 2011 and 2016. All patients had undergone computed tomography, as well as endocrinological tests to confirm the diagnosis prior to the adrenalectomy. The primary endpoint was improved metabolic parameters relating to diabetes, hypertension, dyslipidemia, and obesity. RESULTS: Patients with SCS compared to those with NFA showed a higher occurrence of diabetes (29.5% vs. 11.4%), hypertension (59.1% vs. 34.3%), and dyslipidemia (43.2% vs. 14.3%). Patients with SCS showed a smaller median tumor size compared to those with NFA (2.5 cm vs. 5 cm). No significant perioperative complications ≥ Clavien-Dindo classification grade III were observed in any patient (SCS or NFA group). In terms of their metabolic profile, patients with SCS showed a significant postoperative improvement in hypertension (50.0%), diabetes (53.9%), dyslipidemia (31.6%), and obesity (29.2%). However, patients with NFA showed a postoperative improvement only in dyslipidemia (40.0%) and obesity (4.8%). CONCLUSIONS: Owing to absence of significant perioperative complications and the marked postoperative improvement in metabolic impairment, LA is a useful treatment strategy in patients diagnosed with SCS. In contrast, LA was not observed to show beneficial effects in correcting/improving the metabolic profile in patients presenting with NFA.
Adenoma* ; Adrenalectomy* ; Classification ; Cushing Syndrome* ; Diagnosis ; Dyslipidemias ; Humans ; Hypertension ; Metabolome ; Obesity ; Retrospective Studies

A 8-yrs-old boy was admitted because of convulsion and coma. The diagnosis of Cushing's syndrome(key word) associated with hypertensive encephalopathy(key word) due to right adrenocortical carcinoma(key word) was made by clinical features, biochemical studies, radiological studies and pathological examination. The tumor was successfully resected by right adrenalectomy. But 22 months later after operation, he died of dyspnea and heart failure. A brief review of literature was presented.
Adrenalectomy ; Coma ; Cushing Syndrome* ; Diagnosis ; Dyspnea ; Heart Failure ; Humans ; Hypertension ; Hypertensive Encephalopathy* ; Male ; Seizures

A 8-yrs-old boy was admitted because of convulsion and coma. The diagnosis of Cushing's syndrome(key word) associated with hypertensive encephalopathy(key word) due to right adrenocortical carcinoma(key word) was made by clinical features, biochemical studies, radiological studies and pathological examination. The tumor was successfully resected by right adrenalectomy. But 22 months later after operation, he died of dyspnea and heart failure. A brief review of literature was presented.
Adrenalectomy ; Coma ; Cushing Syndrome* ; Diagnosis ; Dyspnea ; Heart Failure ; Humans ; Hypertension ; Hypertensive Encephalopathy* ; Male ; Seizures