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Temporal fat pad sign during corticosteroid treatment
Archives of Internal Medicine
|November 1, 1980
Summary
Hypercortisolism, a condition of excess cortisol, can cause unusual fat deposits, including prominent painless masses on the temples. This finding highlights an underrecognized symptom of glucocorticoid excess.
Area of Science:
- Endocrinology
- Dermatology
- Pathology
Background:
- Hypercortisolism, characterized by excess cortisol, leads to characteristic fat redistribution.
- Common manifestations include truncal obesity, moon facies, and buffalo hump.
- Systemic glucocorticoid therapy can induce iatrogenic hypercortisolism.
Observation:
- A patient with mixed collagen vascular disease on high-dose prednisone developed bilateral, painless temporal masses.
- These masses were associated with classic signs of hypercortisolism, such as moon facies.
- Histopathological examination of the temporal masses revealed normal adipose tissue.
Findings:
- The study describes prominent painless bitemporal masses as an unappreciated manifestation of hypercortisolism.
- These localized fatty deposits are distinct from typical fat redistribution patterns.
- Biopsy confirmed the masses were composed of normal adipose tissue, suggesting a positional or distributional change rather than abnormal growth.
Implications:
- Recognizing bitemporal masses as a potential sign of hypercortisolism is crucial for timely diagnosis and management.
- This finding expands the spectrum of clinical manifestations associated with glucocorticoid excess.
- Further research is warranted to understand the precise mechanism behind this specific fat deposition pattern.