Cushing's syndrome secondary to a neuroendocrine tumor: relapse after bilateral adrenalectomy

Bilateral adrenalectomy results in the removal of the site of glucocorticosteroid production thereby eliminating the signs and symptoms of Cushing's syndrome. A case is reported of a middle-aged man with Cushing's syndrome due to an ACTH-producing tumor. The patient initially responded to adrenalectomy but had a fatal relapse. Autopsy showed that the right adrenal bed containing remnants of adrenal tissue. An islet cell carcinoma of the pancreas was thought to be the primary tumor.