Cushing syndrome due to adrenal tumor : Symptoms & Signs, Diagnosis & Tests

Symptoms & Signs

Symptoms usually include:

  • Upper body obesity (above the waist) and thin arms and legs
  • Round, red, full face (moon face)
  • Slow growth rate in children

Skin changes that are often seen:

  • Acne or skin infections
  • Purple marks (1/2 inch or more wide) called striae on the skin of the abdomen, thighs, and breasts
  • Thin skin with easy bruising

Muscle and bone changes include:

  • Backache, which occurs with routine activities
  • Bone pain or tenderness
  • Collection of fat between the shoulders (buffalo hump)
  • Thinning of the bones, which leads to rib and spine fractures
  • Weak muscles

Women often have:

  • Excess hair growth on the face, neck, chest, abdomen, and thighs
  • Menstrual cycle becomes irregular or stops

Men may have:

  • Decreased fertility
  • Decreased or no desire for sex
  • Impotence

Other symptoms that may occur include:

  • Mental changes, such as depression, anxiety, or changes in behavior
  • Fatigue
  • Headache
  • High blood pressure
  • Increased thirst and urination

Diagnosis & Tests

Tests to confirm Cushing syndrome:

  • 24-hour urine sample to measure the following:
    • Urine cortisol
    • Urine creatinine
  • Dexamethasone suppression test
  • Serum cortisol levels

Tests to determine cause:

  • Abdominal CT
  • ACTH
  • High-dose dexamethasone suppression test

Other findings may include:

  • High cholesterol
  • High fasting glucose
  • Low bone density, seen by dual x-ray absorptiometry (DEXA)
  • Low serum potassium


Review Date : 9/20/2008
Reviewed By : David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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