ectopic cushing's syndrome of unknown origin: a rare case report

Background: cushing’s syndrome is a rare disease caused by excessive secretion of cortisol by adrenal cortex (hypercortisolism). bilateral adrenal hyperplasia due to increased secretion of adrenocorticotropic hormone (acth) by pituitary gland is usually known as the main cause of cushing’s syndrome. the 5- year survival rate for patient with cushing’s syndrome is approximately 50% unless associated with treatment. etiologic diagnosis therefore plays an important role in prompt treatment. the purpose of this study is to inspect a cushing’s syndrome with unknown cause. case presentation: a 36-year-old married man with complaint of periorbital and upper trunk swelling (with no buffalo hump) and lower extremity weakness presented to doctor’s clinic. he also had a one-year history of blurred vision, hypertension, facial and periorbital edema and difficulty getting up from a sitting. after physical examinations and laboratory testing, diagnosis of cushing’s disease with unknown cause was made and surgical removal of both adrenal glands was suggested. he underwent bilateral adrenalectomy in two separate operations and his symptoms gradually reduced during the next months. conclusion: according to this study and other same case report studies conducted, surgical removal of adrenal gland is the most effective treatment if the patient does not respond to medication. even if the cause of cushing’s disease is not known, like the case mentioned.