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Cushing's syndrome in women with polycystic ovaries and hyperandrogenism

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From Nature Clinical Practice Endocrinology & Metabolism

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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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Figure 1: Abdominal CT scan and patient's appearance.

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Acknowledgements

N Krone is a Wellcome Trust Clinician Scientist. NA Hanley received support as a UK Department of Health Clinician Scientist. Written consent for publication of Figure 1 was obtained from the patient.

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Authors and Affiliations

  1. PG Fegan is a Wessex Region Specialist Registrar in Diabetes and Endocrinology.,

    P Gerry Fegan

  2. DD Sandeman is a Consultant Endocrinologist and PJ Wood is a Consultant Biochemist at Southampton University Hospitals NHS Trust, Southampton, UK.,

    Derek D Sandeman & Peter J Wood

  3. N Krone is a Wellcome Trust Clinician Scientist Fellow and PM Stewart is Professor of Medicine, at the University of Birmingham, Birmingham, UK.,

    Nils Krone & Paul M Stewart

  4. D Bosman is a Consultant Endocrinologist at The Royal West Sussex Trust, Chichester, UK.,

    Deborah Bosman

  5. NA Hanley is Professor of Endocrinology, at the University of Southampton, UK.,

    Neil A Hanley

Authors
  1. P Gerry Fegan
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  2. Derek D Sandeman
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  3. Nils Krone
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  4. Deborah Bosman
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  5. Peter J Wood
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  6. Paul M Stewart
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  7. Neil A Hanley
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Corresponding author

Correspondence to Neil A Hanley.

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The authors declare no competing financial interests.

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Fegan, P., Sandeman, D., Krone, N. et al. Cushing's syndrome in women with polycystic ovaries and hyperandrogenism. Nat Rev Endocrinol 3, 778–783 (2007). https://doi.org/10.1038/ncpendmet0665

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  • DOI: https://doi.org/10.1038/ncpendmet0665

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