Cushing's syndrome in women with polycystic ovaries and hyperandrogenism

Fegan, P. Gerry, Sandeman, Derek D., Krone, Nils, Bosman, Deborah, Wood, Peter J., Stewart, Paul M. and Hanley, Neil A. (2007) Cushing's syndrome in women with polycystic ovaries and hyperandrogenism. Nature Clinical Practice Endocrinology & Metabolism, 3 (11), 778-783. (doi:10.1038/ncpendmet0665).

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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