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December 11, 1981

Cushing's Disease in a Patient With an Ectopic Pituitary Adenoma

Author Affiliations

From the Division of Endocrinology, Oregon Health Sciences University and Providence Medical Center, Portland.

JAMA. 1981;246(23):2722-2724. doi:10.1001/jama.1981.03320230046024

THE OCCURRENCE of pituitary tissue in an ectopic location but not in continuity with intrasellar pituitary tissue has been previously reported.1-7 However, pituitary dysfunction in such patients is uncommon.1-3 We describe here a patient with pituitary-dependent Cushing's syndrome who had a chromophobe adenoma located in the sphenoid sinus.

Report of a Case  A 51-year-old woman was admitted to our medical center in 1976 for evaluation of persistent microscopic hematuria. This was first noted two years earlier on routine urinalysis and on repeated examinations. Findings from renal function tests, intravenous pyelogram, and cystoscopy were considered normal. She was known to have arterial hypertension for at least five years. Her blood pressure (BP) responded favorably to medication until three months before admission, when it became difficult to control. During this period the patient noted increasing weakness, malaise, puffiness of her face, facial hair, increasing skin pigmentation, and weight gain. Her