Cushing's syndrome [Neurosurgery Wiki]

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====== Cushing's syndrome ======

{{ ::cushingssyndrome.png?400|}}

Cushing’s [[syndrome]] (CS) is a constellation of findings caused by [[hypercortisolism]]. 

===== Epidemiology =====

The most common cause of Cushing's syndrome (CS) is iatrogenic (administration of exogenous [[steroid]]s). 

Cushing's syndrome is a rare disease that is caused by the over production of [[cortisol]] by the [[adrenal gland]]s.

Adrenocorticotropin hormone (ACTH)-dependent Cushing's syndrome is caused by [[Cushing's disease]] (around 85%) and ectopic ACTH-secreting tumors (approximately 15%)
((Stewart PM, Krone NP. 12th ed. Philadelphia: Elsevier Saunders; 2011. The Adrenal Cortex. Williams Text Book of Endocrinology; pp. 479–544.)).

This can be caused by a tumor of the adrenal glands, the [[lung]]s, or the [[pituitary gland]]. When the tumor produces too much [[ACTH]], it causes over production of cortisol by the adrenal glands. If the source is the pituitary, it is called [[Cushing's disease]]
((Gardner D, editor. New York: The McGraw-Hill Company; 2007. Greenspan's Basic and Clinical Endocrinology (eight edition Ed.))

Expert opinion and a consensus statement on Cushing syndrome (CS) indicate that, in a patient with a clinical presentation and biochemical studies consistent with a pituitary etiology, the presence of a pituitary tumor ≥6 mm is highly suggestive of [[Cushing disease]] (CD).

This is most often as a result of [[Pituitary corticotroph adenoma]].

===== Etiology =====

[[Cushing's syndrome etiology]].


===== Clinical features =====

see [[Cushing's syndrome clinical features]]

===== Diagnosis =====
see [[Cushing's syndrome diagnosis]]

===== Treatment =====
Definite treatment of Cushing's syndrome is surgical removal of ACTH-secreting lesion and prerequisite for this surgical management requires localization of ACTH-secreting source
((Katznelson L, Bogan JS, Trob JR, Schoenfeld DA, Hedley-Whyte ET, Hsu DW, et al. Biochemical assessment of Cushing's disease in patients with corticotroph macroadenomas. J Clin Endocrinol Metab. 1998;83:1619–23.)).

===== Case series =====

[[Cushing's syndrome case series]].