Differential Diagnosis of Cushing's Syndrome

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Abstract
Endogenous Cushing's syndrome continues to tax the diagnostic skills of many physicians because it is an unusual disorder with which they have had little experience and because no single diagnostic test has proved to be completely reliable.Cushing's syndrome is either adrenocorticotropin-dependent or adrenocorticotropin-independent. The dependent type is due to hypersecretion of adrenocorticotropin by a pituitary adenoma (Cushing's disease) or by a nonpituitary tumor (ectopic adrenocorticotropin syndrome) with secondary adrenal hyperplasia and hypersecretion of cortisol or, extremely rarely, to secretion of corticotropin-releasing hormone (CRH) by nonhypothalamic tumors with secondary pituitary corticotroph hyperplasia and adrenocorticotropin hypersecretion (ectopic CRH syndrome). The adrenocorticotropin-independent . . .