Cushing's syndrome associated with a pheochromocytoma

A norepinephrine producing right adrenal pheochromocytoma was associated with bilateral adrenal hyperplasia and clinically and biochemically evident Cushing's syndrome. Ectopic adrenocorticotropin production was suspected, but the six criteria for proof of ectopic adrenocorticotropin production could not be demonstrated. The diagnosis of Cushing's syndrome from ectopic hormone production by a pheochromocytoma requires a high index of suspicion and extensive biochemical and radiographic testing to confirm Cushing's syndrome, identify the cause of Cushing's syndrome, and localize the pheochromocytoma.