[Plasma ACTH and Nelson tumors in bilaterally adrenalectomized Cushing patients]

Bilaterally adrenalectomized patients (18) because of Cushing's syndrome were studied. 16 of these 18 persons exhibited fairly high plasma ACTH levels. Distinctly elevated plasma ACTH levels were observed in 6 of them. 5 patients of this group showed an enlarged sella and deep pigmentation of the skin. 4 of the latter group had a mucoid cell adenoma which was removed selectively. After the surgery the ACTH values were found to be within normal range without any significant endocrine dysfunction of the pituitary. A long-term ACTH survey revealed that the ACTH levels remained within the ranges of bilaterally adrenalectomized Cushing patients without concomitant enlargement of the sella or pigmentation.