ABSTRACT
@EN Cushing's syndrome caused by ACTH secreting pituitary adenoma or by corticotroph hyperplasia is referred to Cushing's disease. Since the original description of Cushing's disease by Harvey Cushing in 1932, there has been marked progression in
the
etiology, diagnosis and treatment of this disorder. Despite the progression, the diverse clinical, endocrinological, radiological and pathological features of Cushing's disease remain incompletely understood and there also remain many problems to
be
resolved about the diagnosis, treatment, and prognosis of Cushing's disease.
Sixteen cases with Cushing's disease were evaluated in this study. @ES The following results were obtained.
@EN 1) The patients consist of 12 females and 4 males and the age was ranged from 18 to 47 years.
2) Among 16 patients, 14 patients showed central obesity and buffalo hump, 13 moon face. Among 12 female patients, 10 patients showed abnormalities of menstration.
3) Elevated levels and loss of diurnal variation of the serum cortisol were observed in all patients, and increased 24hr urine free cortisol in 11 out of 12 patients tested. Urinary cortisol excretion was not suppressed by low dose dexamethasone
suppression test but suppressed by high dose dexamethasone test.
4) Computed tomogram and MRI revealed that 15 cases were microadenoma and 1 was macroadenoma.
5) The modalities of treatment were TSA (11 cases), TSA with Radiotherapy (2 cases), and r-knife radiotherapy (3 cases).
6) During the follow up periods (2~31 months), 2 cases were recurred.
In conclusion, 15 cases of 16 Cushing's disease were microadenoma. The standard dexamethasone suppression test was useful in the biochemical diagnosis, and inferior petrous venous sampling was also needed to clarify the localization of tumor
which
was
not detected by MRI or CT scan. (J Kor Soc Endocrinol 8:273~280, 1993)
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