Cushing Syndrome

Basics

Cushing disease: Pituitary adenoma producing excess adrenocorticotropic hormone (ACTH)
Cushing syndrome: Excessive glucocorticoid effects

Genetics

Multiple endocrine neoplasia (MEN) type I
Carney complex (pigmented lentigines, atrial myxoma, germ-cell tumors with Cushing disease)

Most commonly exogenous administration of glucocorticoids either therapeutically or surreptitiously
Pituitary adenoma secreting ACTH
Adrenal production of cortisol from adenoma, carcinoma, or micronodular disease
Tumor-producing ectopic ACTH:
- Small cell lung carcinoma:
  - Most common
- Uterine cervical carcinoma
- Islet cell tumor of pancreas:
  - Multiple endocrine neoplasia (MEN) type I syndrome
- Medullary thyroid cancer
- Pheochromocytoma
- Ganglioneuroma
- Melanoma prostate carcinoma
- Carcinoid tumor:
  - Lung
  - Pancreas
  - GI tract
  - Thymus
  - Ovary

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