Cushing's syndrome results from inappropriate excessive endogenous glucocorticoids secretion. It may be due to ACTH-producing pituitary adenoma, Adrenocortical adenoma, iatrogen glu-cocorticoid use, or ectopic ACTH production. Pa-tients, who remain untreated, have high morbid-ity and a significant mortality. We describe a very challenging case of Cushing's syndrome due an adrenal adenoma on a pancreatic mass. Material and Methods: A 20-year-old woman presented with sign and symptoms of Cushing syndrome. Thorough basal and dynamic hor-monal assessment. In addition, the results of im-aging studies are presented. Results: The source of ACTH secretion was adrenal adenoma, and hypercortisolism was con-trolled by adrenalectomy. A unique feature of this case is the fact that we observed an adrenal adenoma as a source of Cushing syndrome and an incidental nonfunctional pancreatic nesidiob-lastosis. Conclusion: The diagnosis of Cushing's syn-drome may turn out to be sometimes a complex and time-consuming challenge in clinical endo-crinology.
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