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  • Title: Cushing's syndrome in women with polycystic ovaries and hyperandrogenism.
    Author: Fegan PG, Sandeman DD, Krone N, Bosman D, Wood PJ, Stewart PM, Hanley NA.
    Journal: Nat Clin Pract Endocrinol Metab; 2007 Nov; 3(11):778-83. PubMed ID: 17955019.
    Abstract:
    BACKGROUND: A 41-year-old woman presented to an endocrinology-gynecology clinic having been diagnosed 7 years earlier with polycystic ovarian syndrome on account of hirsutism, subfertility, greasy skin, acne and multiple ovarian cysts. Ovulation induction had led to a successful pregnancy. Subfertility recurred, however, and persisted alongside a new diagnosis of hypertension and progressive weight gain. Upon examination, the patient was hypertensive with facial plethora, rounded facies and violaceous abdominal striae. INVESTIGATIONS: Low-dose dexamethasone test, bedtime salivary and 24-h urinary free cortisol estimations, CT scan of the abdomen, and serum hormone and gonadotropin analyses. DIAGNOSIS: Cushing's syndrome due to a right adrenocortical adenoma. MANAGEMENT: The patient underwent laparoscopic right adrenalectomy, which led to resolution of all symptoms, signs and biochemical abnormalities.
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