PMC6378481_01
Abdomen computed tomography of a young female patient with florid Cushing's syndrome (2 years after initial surgery with no subsequent mitotane treatment), showing relapsed adrenocortical carcinoma (65 x 40 mm, black arrow) despite previous resection, with massive liver metastasis also present.
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Imaging revealed a mass of 65 x 40 mm in the side of the previous resection and massive liver metastases (Figure 1).
PMC6378481_02
Magnetic resonance imaging of the pituitary region, showing microcorticotropinoma (white arrow) in a young male patient with severe Cushing's syndrome.
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To our puzzlement, eventually, bilateral inferior petrosal sinus sampling helped to confirm the diagnosis of pituitary corticotropinoma (Figure 2) and the patient underwent effective trans-sphenoidal surgical resection of the tumour.
PMC6378481_03
Chest and abdomen computed tomography scanning of metastatic, inoperable ACTH-secreting lung carcinoid (white arrow) in a 66-year-old female with severe ectopic Cushing's syndrome.. ACTH, adrenocorticotropic hormone.
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A 66-year-old female with ectopic CS due to a metastatic lung carcinoid with liver lesions underwent a left adrenalectomy three months earlier as the first step of complete adrenal gland removal and was referred to the Department of Endocrinology with severe hypercortisolaemia, decompensation of diabetes, severe hypokalaemia and mood disorders (Figure 3).