Caused by prolonged exposure to cortisol, either from medications or due to a tumor.Encyclopedia Entry for Cushing Syndrome :Cushing syndrome due to adrenal tumor. Cushing syndrome is a disorder that occurs when your body has a higher than normal level of the hormone cortisol. This hormone is made in the adrenal glands. Too much cortisol can be due to various problems. One such problem is a tumor on one of the adrenal glands. Adrenal tumors release cortisol. Adrenal tumors are rare. They can be noncancerous (benign) or cancerous (malignant). Noncancerous tumors that can cause Cushing syndrome include: Adrenal adenomas, a common tumor that rarely makes excess cortisol Macronodular hyperplasia , which causes the adrenal glands to enlarge and make excess cortisol Cancerous tumors that may cause Cushing syndrome include an adrenal carcinoma. This is a rare tumor, but it usually makes excess cortisol.Most people with Cushing syndrome have: Round, red, full face ( moon face ) Slow growth rate in children Weight gain with fat accumulation on the trunk, but fat loss from the arms, legs, and buttocks (central obesity) Skin changes that are often seen: Skin infections Purple stretch marks (1/2 inch or 1 centimeter or more wide), called striae , on the skin of the abdomen, thighs, upper arms, 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 and above the collar bone Rib and spine fractures caused by thinning of the bones Weak muscles, especially of the hips and shoulders Body-wide (systemic) changes include: Type 2 diabetes mellitus High blood pressure Increased cholesterol and triglycerides Women often have: Excess hair growth on the face, neck, chest, abdomen, and thighs (more common than in other types of Cushing syndrome) Periods that become irregular or stop Men may have: Decreased or no desire for sex (low libido) Erection problems Other symptoms that may occur include: Mental changes, such as depression, anxiety, or changes in behavior Fatigue Headache Increased thirst and urination.The health care provider will perform a physical exam and ask about your symptoms. Tests to confirm Cushing syndrome: 24-hour urine sample to measure cortisol and creatinine levels Blood tests to check ACTH, cortisol, and potassium levels Dexamethasone suppression test Blood cortisol levels Blood DHEA level Saliva cortisol level Tests to determine cause or complications include: Abdominal CT ACTH Bone mineral density Cholesterol Fasting glucose.Surgery is done to remove the adrenal tumor. Often, the entire adrenal gland is removed. Glucocorticoid replacement treatment is usually needed until the other adrenal gland recovers from surgery. You may need this treatment for 9 to 12 months. If surgery is not possible, such as in cases of adrenal cancer, medicines can be used to stop the release of cortisol.People with an adrenal tumor who have surgery have an excellent outlook. For adrenal cancer, surgery is sometimes not possible. When surgery is performed, it does not always cure the cancer.Cancerous adrenal tumors can spread to the liver or lungs.Call your provider if you develop any symptoms of Cushing syndrome.Appropriate treatment of adrenal tumors may reduce the risk of complications in some people with tumor-related Cushing syndrome.Adrenal tumor - Cushing syndrome.Endocrine glands Endocrine glands Adrenal metastases, CT scan Adrenal metastases, CT scan Adrenal Tumor - CT Adrenal Tumor - CT.Nieman LK, Biller BM, Findling JW, et al. Treatment of Cushing's syndrome: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2015;100(8):2807-2831. PMID: 26222757 www.ncbi.nlm.nih.gov/pubmed/26222757. Schneider DF, Mazeh H, Lubner SJ, Jaume JC, Chen H. Cancer of the endocrine system.Encyclopedia Entry for Cushing Syndrome :Cushing syndrome. The most common cause of Cushing syndrome is taking too much glucocorticoid or corticosteroid medicine. This form of Cushing syndrome is called exogenous Cushing syndrome. Prednisone, dexamethasone, and prednisolone are examples of this type of medicine. Glucocorticoids mimic the action of the body's natural hormone cortisol. These drugs are used to treat many conditions such as asthma, skin inflammation, cancer, bowel disease, joint pain, and rheumatoid arthritis. Other people develop Cushing syndrome because their body produces too much cortisol. This hormone is made in the adrenal glands. Causes of too much cortisol are: Cushing disease , which occurs when the pituitary gland makes too much of the hormone ACTH. ACTH then signals the adrenal glands to produce too much cortisol. A pituitary gland tumor can cause this condition. Tumor of the adrenal gland Tumor elsewhere in the body that produces corticotropin-releasing hormone (CRH) Tumors elsewhere in the body that produce ACTH ( ectopic Cushing syndrome ).Symptoms vary. Not everyone with Cushing syndrome has the same symptoms. Some people have many symptoms while others have hardly any symptoms. Most people with Cushing syndrome have: Round, red, full face ( moon face ) Slow growth rate (in children) Weight gain with fat accumulation on the trunk, but fat loss from the arms, legs, and buttocks (central obesity) Skin changes can include: Skin infections Purple stretch marks (1/2 inch or 1 centimeter or more wide) called striae on the skin of the abdomen, upper arms, thighs, and breasts Thin skin with easy bruising (especially on the arms and hands) Muscle and bone changes include: Backache, which occurs with routine activities Bone pain or tenderness Collection of fat between the shoulders and above collar bones Rib and spine fractures caused by thinning of the bones Weak muscles, especially of the hips and shoulders Body-wide (systemic) changes include: Type 2 diabetes mellitus High blood pressure (hypertension) Increased cholesterol and triglycerides (hyperlipidemia) Women with Cushing syndrome may have: Excess hair growth on the face, neck, chest, abdomen, and thighs Periods that become irregular or stop Men may have: Decreased or no desire for sex (low libido) Erection problems Other symptoms that may occur with this disease: Mental changes, such as depression, anxiety, or changes in behavior Fatigue Headache Increased thirst and urination.The health care provider will perform a physical exam and ask about your symptoms and the medicines you are taking. Tell the provider about all medicines you have been taking for the past several months. Also tell the provider about shots that you received at a provider's office. Laboratory tests that may be done to diagnose Cushing syndrome and identify the cause are: Blood cortisol level Blood sugar Saliva cortisol level Dexamethasone suppression test 24-hour urine for cortisol and creatinine ACTH level ACTH stimulation test (rarely) Tests to determine the cause or complications may include: Abdominal CT Pituitary MRI Bone mineral density.Treatment depends on the cause. Cushing syndrome caused by corticosteroid use: Your provider will instruct you to slowly decrease the medicine dosage. Stopping the medicine suddenly can be dangerous. If you cannot stop taking the medicine because of disease, your high blood sugar, high cholesterol levels, and bone thinning or osteoporosis should be closely monitored. With Cushing syndrome caused by a pituitary or a tumor that releases ACTH (Cushing disease), you may need: Surgery to remove the tumor Radiation after removal of a pituitary tumor (in some cases) Cortisol replacement therapy after surgery Medicines to replace pituitary hormones that become deficient Medicines to prevent the body from making too much cortisol With Cushing syndrome due to an adrenal tumor or other tumors: You may need surgery to remove the tumor. If the tumor cannot be removed, you may need medicines to help block the release of cortisol.Removing the tumor may lead to full recovery, but there is a chance that the condition will return. Survival for people with Cushing syndrome caused by tumors depends on the tumor type. Untreated, Cushing syndrome can be life threatening.Health problems that may result from Cushing syndrome include any of the following: Diabetes Enlargement of pituitary tumor Fractures due to osteoporosis High blood pressure Kidney stones Serious infections.Call your provider if you have symptoms of Cushing syndrome.If you take a corticosteroid, know the signs and symptoms of Cushing syndrome. Getting treated early can help prevent any long-term effects of Cushing syndrome. If you use inhaled steroids, you can decrease your exposure to the steroids by using a spacer and by rinsing your mouth after breathing in the steroids.Hypercortisolism; Cortisol excess; Glucocorticoid excess - Cushing syndrome.Endocrine glands Endocrine glands.Nieman LK, Biller BM, Findling JW, et al; Endocrine Society. Treatment of Cushing's syndrome: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2015;100(8):2807-2831. PMID: 26222757 www.ncbi.nlm.nih.gov/pubmed/26222757. Stewart PM, Newell-Price JDC. The adrenal cortex.