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ACTH-dependent Cushing's Syndrome: Diagnostic Pitfalls in Concomitant Non-secreting Pituitary Adenomas
Pietro Lucotti1, Cesare Zoia2, Elisabetta Lovati1
1First Department of Medicine, IRCCS Fondazione Policlinico San Matteo, Pavia, Italy.
Objectives:
To describe the possible pitfalls in correctly interpreting clinical, radiological and biochemical findings in ACTH-dependent Cushing's syndrome.
Methods:
We describe a case of a pituitary adenoma visualized at MRI not correlated with an ACTH-dependent Cushing's syndrome.
Results:
Radiological imaging and hormonal testing can be misleading in suspected pituitary ACTH-related Cushing's syndrome.
Conclusion:
Correct interpretation of the initial clinical presentation can help in the proper diagnosis and treatment of ACTH-dependent Cushing's syndrome.
Learning Points:
Occult neoplasia should always be excluded in cases of severe ACTH-dependent Cushing's syndrome.A positive MRI result can be misleading. Ectopic ACTH-dependent syndrome is generally associated with a peculiar phenotype.
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