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Cushing's syndrome in women with polycystic ovaries and hyperandrogenism.

Fegan PG, Sandeman DD, Krone N, Bosman D, Wood PJ, Stewart PM, Hanley NA

School of Medicine, University of Southampton, Duthie Building / Mailpoint 808, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK.

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.

Published 23 October 2007 in Nat Clin Pract Endocrinol Metab, 3(11): 778-83.
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