April 1976

Cushing Syndrome With Cyclical Edema and Periodic Secretion of Corticosteroids

Author Affiliations

From the departments of medicine B and thoracic and vascular surgery, Hadassah University Hospital, Jerusalem, Israel.

Arch Intern Med. 1976;136(4):441-443. doi:10.1001/archinte.1976.03630040043009

Isolated studies of cyclical adrenocortical activity in patients with functioning tumors have been reported previously1,2; however, to our knowledge, cyclical hormone secretions correlated with changes in the clinical picture of Cushing syndrome has not yet been recorded. We report here a patient with a malignant carcinoid tumor of the lung in whom cyclical edema was the outstanding feature of the clinical picture, and in whom periodic secretion of corticosteroids was closely associated with fluctuations of fluid retention.

PATIENT SUMMARY  A 56-year-old woman was admitted to the Hadassah University Hospital in January 1973. She had been well until 18 months before admission, when she noted dependent edema that would appear every 7 to 10 days and last for about two to three days, during which time she would gain 2 to 4 kg (4.4 to 8.8 lb) in weight (Fig 1). Following this accumulation of fluid, there would be a

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