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Diagnosis in the cushing's syndrome revisited

Journal Article:

Abstract

The diagnostic procedure for the differential diagnosis of Cushing's syndrome is reported in this paper based on the experience of 23 cases. Inappropiate cortisol secretion was established by an absent cortisol circadian rhythm and absent cortisol suppression after overnight dexamethasone suppression test. The ACTH serum levels were then determined in basal conditions and after insulin-induced hypoglycemia (0.15 U/kg b.w. insulin i.v.). ACTH was low or undetectable in 9 patients, and high or normal-high in 14 patients. In the first group of patients an adrenal trasmission computed tomography (CT) was performed and showd an adrenal adenima in 6 patients, adrenal carcinoma in 2 patients and hyperplasia of residual adrenal gland in 1 patient, who had previously undergone monolateral adrenalectomy. These patients underwent surgical treatment, except the patient with adrenal hyperplasia. In the second group of patients, negative in 4 patients, doubtful in 1 patient. Surgical exploration by transsphenoidal route was performed, and an ACTH-producing adenima removed in all cases. Radicalization with hypophysectomy was necessary in 2 patients, while other 2 patients are under observation for the suspicion of a recurrent pituitary tumor. In all patients adrenal scintiscan was also performed, and confirmed the suspicion pointed out by CT scan. A relatively  More>>
Publication Date:
Jan 01, 1986
Product Type:
Journal Article
Reference Number:
AIX-19-013007; EDB-88-031393
Resource Relation:
Journal Name: J. Nucl. Med. Allied Sci.; (Italy); Journal Volume: 30:1
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; CUSHING SYNDROME; COMPUTERIZED TOMOGRAPHY; DIAGNOSIS; SURGERY; DIAGNOSTIC TECHNIQUES; DISEASES; ENDOCRINE DISEASES; MEDICINE; TOMOGRAPHY; 550602* - Medicine- External Radiation in Diagnostics- (1980-)
OSTI ID:
5667180
Research Organizations:
Univ. Cattolica del Sacro Cuore, Rome, Italy. Ist. di Radiologia
Country of Origin:
Italy
Language:
English
Other Identifying Numbers:
Journal ID: CODEN: JNMSD
Submitting Site:
INIS
Size:
Pages: 1-13
Announcement Date:

Journal Article:

Citation Formats

De Marinis, L, Mancini, A, and D'Amico, C and others. Diagnosis in the cushing's syndrome revisited. Italy: N. p., 1986. Web.
De Marinis, L, Mancini, A, & D'Amico, C and others. Diagnosis in the cushing's syndrome revisited. Italy.
De Marinis, L, Mancini, A, and D'Amico, C and others. 1986. "Diagnosis in the cushing's syndrome revisited." Italy.
@misc{etde_5667180,
title = {Diagnosis in the cushing's syndrome revisited}
author = {De Marinis, L, Mancini, A, and D'Amico, C and others}
abstractNote = {The diagnostic procedure for the differential diagnosis of Cushing's syndrome is reported in this paper based on the experience of 23 cases. Inappropiate cortisol secretion was established by an absent cortisol circadian rhythm and absent cortisol suppression after overnight dexamethasone suppression test. The ACTH serum levels were then determined in basal conditions and after insulin-induced hypoglycemia (0.15 U/kg b.w. insulin i.v.). ACTH was low or undetectable in 9 patients, and high or normal-high in 14 patients. In the first group of patients an adrenal trasmission computed tomography (CT) was performed and showd an adrenal adenima in 6 patients, adrenal carcinoma in 2 patients and hyperplasia of residual adrenal gland in 1 patient, who had previously undergone monolateral adrenalectomy. These patients underwent surgical treatment, except the patient with adrenal hyperplasia. In the second group of patients, negative in 4 patients, doubtful in 1 patient. Surgical exploration by transsphenoidal route was performed, and an ACTH-producing adenima removed in all cases. Radicalization with hypophysectomy was necessary in 2 patients, while other 2 patients are under observation for the suspicion of a recurrent pituitary tumor. In all patients adrenal scintiscan was also performed, and confirmed the suspicion pointed out by CT scan. A relatively simple protocol with a functional test (ACTH determination) and a morphological one (computed tomography), can be reliably applied in the differential diagnosis of Cushing syndrome. 62 refs.}
journal = {J. Nucl. Med. Allied Sci.; (Italy)}
volume = {30:1}
journal type = {AC}
place = {Italy}
year = {1986}
month = {Jan}
}