Cushing syndrome due to adrenal tumor

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Adrenal metastases, CT scan

Adrenal Tumor - CT

Endocrine glands

Adrenal tumor - Cushing syndrome

• Moon face (round, red, and full)
• Weight gain
  • Buffalo hump (a collection of fat between the shoulders)
  • The weight gain has a particular pattern -- a protruding abdomen and thin extremities
• Skin changes
  • Thinning of the skin
  • Easy bruising
  • Acne or other skin infections
  • Purple streaks on the skin of the abdomen, thighs, and breasts
• High blood pressure
• Weakness (often noticed when trying to stand up or to raise hand above head)
• Backache
• Headache
• Thirst
• Increased urination
• Mental changes, including an exaggerated feeling of happiness (euphoria), not linked to a life event
• Stopping of menstruation in women
• Breast development and impotence in men

Patients with a cancerous adrenal tumor may also have symptoms of higher-than-normal androgen levels, including excessive hair in unusual parts of the body (in women), acne, and scalp hair loss.

Tests to confirm Cushing syndrome:

• 24-hour urine sample to measure the following:
  • Urine cortisol
  • Urine creatinine
• Dexamethasone suppression test
• Serum cortisol levels
• Saliva cortisol levels

Tests to determine cause:

• ACTH
• High-dose dexamethasone suppression test
• Abdominal CT (may show adrenal tumor)

Other findings may include:

• High fasting glucose
• Low serum potassium
• Low bone density, seen by dual x-ray absorptiometry (DEXA)
• High cholesterol

Review Date: 08/08/2006
Reviewed By: Robert Hurd, MD, Department of Biology, College of Arts and Sciences, Xavier University, Cincinnati, OH. Review provided by VeriMed Healthcare Network.