PMID- 10096147
OWN - NLM
STAT- MEDLINE
DCOM- 19990527
LR  - 20191103
IS  - 0724-4983 (Print)
IS  - 0724-4983 (Linking)
VI  - 17
IP  - 1
DP  - 1999 Feb
TI  - Contemporary evaluation and management of Cushing's syndrome.
PG  - 22-5
AB  - Cushing's syndrome, characterized by unregulated cortisol secretion, may be 
      caused by a variety of adrenal, pituitary, or other tumors. The best biochemical 
      test for establishing the diagnosis is determination of 24-h urinary free 
      cortisol. The specific causes for Cushing's syndrome may be further 
      differentiated by plasma adrenocorticotrophic hormone (ACTH). Primary adrenal 
      cortical diseases are associated with low levels of ACTH and are considered 
      ACTH-independent. Pituitary disease and the ectopic ACTH syndrome are associated 
      with normal or elevated ACTH levels and are considered ACTH-dependent. Adrenal 
      forms of Cushing's syndrome may result from either adenoma or carcinoma. The 
      diagnostic approach to Cushing's syndrome and the clinical, biochemical, and 
      radiographic features that distinguish adrenal adenoma and carcinoma are the 
      subjects of this paper. 65-75% of CS [14, 15]. Most cases of Cushing's disease 
      are the result of pituitary adenomas; however, corticotrope hyperplasia is 
      responsible for a small minority of cases. Ectopic production of ACTH from a 
      variety of tumors (bronchial carciniod, thymoma, oat-cell carcinoma, 
      pheochromocytoma, islet-cell tumor, and prostate cancer) accounts for 10-15% of 
      CS. Primary adrenocortical diseases account for the remaining 20-30% of CS, 
      including benign adenoma (10-15%), adrenocortical carcinoma (5-10%), and 
      adenomatous hyperplasia (5%). The purpose of this review is to present a 
      contemporary approach to the evaluation and management of patients with Cushing's 
      syndrome, emphasizing the primary adrenal etiologies pertinent to urologists.
FAU - Goldfarb, D A
AU  - Goldfarb DA
AD  - Cleveland Clinic Foundation, Department of Urology, OH 44195, USA. 
      goldfad@cesmtp.ccf.org
LA  - eng
PT  - Journal Article
PT  - Review
PL  - Germany
TA  - World J Urol
JT  - World journal of urology
JID - 8307716
SB  - IM
MH  - Cushing Syndrome/*diagnosis/*therapy
MH  - Diagnosis, Differential
MH  - Humans
MH  - Laparoscopy
MH  - Magnetic Resonance Imaging
MH  - Tomography, X-Ray Computed
RF  - 18
EDAT- 1999/03/30 00:00
MHDA- 1999/03/30 00:01
CRDT- 1999/03/30 00:00
PHST- 1999/03/30 00:00 [pubmed]
PHST- 1999/03/30 00:01 [medline]
PHST- 1999/03/30 00:00 [entrez]
AID - 10.1007/s003450050100 [doi]
PST - ppublish
SO  - World J Urol. 1999 Feb;17(1):22-5. doi: 10.1007/s003450050100.