Differential Diagnosis of ACTH-Dependent Hypercortisolism: Case Report and Literature Review.

Authors

Sebastián Oksenberg, Flavia Nilo, Pablo Villanueva, María Isabel Hernández, Claudia González, Juan Pablo Cruz, René Baudrand, Thomas Uslar, José Miguel Domínguez, Francisco J Guarda

Published in

Revista medica de Chile. Volume 154. Issue 7. Pages 1113-1120.

Abstract

Cushing's disease (CD) is an endocrine condition characterized by an excessive production of adrenocorticotropic hormone (ACTH) by the anterior pituitary, which determines an increase in the production of cortisol in the adrenal glands and secondary clinical manifestations. The differential diagnosis includes a corticotropic pituitary tumor or ACTH-producing ectopic neuroendocrine syndrome (EAS). In addition, non tumoral hypercortisolism (NtH) should be taken into account, which may be clinically indistinguishable from CD. Pituitary magnetic resonance imaging (MRI) with gadolinium is the imaging modality of choice; however, conventional MRI can identify only 50-60% of the cases. This has led to the use of bilateral inferior petrosal sinus sampling and the development of dynamic tests, which may allow etiologic certainty and, thus, avoid unnecessary procedures. This review outlines the evidence underpinning the different diagnostic strategies for this disease.

PMID:
42809788
Bibliographic data and abstract were imported from PubMed on 30 Sep 2026.

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