Cushing’s Syndrome

Cushing's disease is a rare form of Cushing's syndrome caused by a pituitary adenoma that secretes excessive adrenocorticotropic hormone (ACTH), leading to hypercortisolism. The adenoma, typically a microadenoma, arises from the anterior pituitary and results in increased ACTH and α-MSH production, stimulating cortisol release from the adrenal glands. It most commonly affects individuals in their third and fourth decades, with an annual incidence of approximately 0.6 per million for benign adrenal adenomas contributing to the condition. Differentiation from other causes of Cushing's syndrome—such as adrenal tumors, exogenous steroid use, or ectopic ACTH production—is crucial. Oral pigmentation may occur only when the syndrome stems from Cushing disease due to elevated α-MSH. The condition remains uncommon in pediatric populations.