Cushing's disease, a rarely occurring endocrine disorder characterized by an over secretion of hormones from a pituitary tumor, can be treated effectively with surgery, radiation or medication. However, if left untreated, Cushing's disease can lead to severe illness and death, according to the National Institute of Neurological Disorders and Stroke and Medline Plus.
Causes
Cushing's disease occurs in response to the growth of a pituitary tumor that secretes excessive amounts of ACTH. The hormone ACTH stimulates the production and secretion of the hormone cortisol from the adrenal glands. Cortisol regulates the use of carbohydrates, fats and proteins and reduces inflammation in the body. However, at high levels, cortisol disrupts normal bodily function. A tumor of the pituitary, also called a pituitary adenoma, causes 70 percent of Cushing's syndrome cases, says the National Endocrine and Metabolic Diseases Information Service.
Signs and Symptoms
Predominate signs and symptoms of Cushing's disease include upper body obesity, slender arms and legs, excessive fat around the neck and a rounded face (moon face). The skin becomes fragile and thin, purple and pink stretch marks appear on the body, bones become weakened, leading to bone pain. Women with Cushing's disease have excessive hair growth on the face, chest, thighs, abdomen and neck, and menstrual periods become irregular or stop. Men with Cushing's disease might experience decreased sex drive, fertility and impotence. Other signs and symptoms include anxiety or depression, high blood glucose and high blood pressure, increased thirst and urination, weak muscles, severe fatigue and a fatty hump on the upper back, according to the National Endocrine and Metabolic Diseases Information Service and Medline Plus.
Exams and Tests
Tests to determine the presence of Cushing's disease include blood tests to measure cortisol and ACTH levels, salivary tests for cortisol level and a 24-hour urine test to measure cortisol and creatinine levels. The second stage of diagnosis involves the determination of tumor location using a pituitary MRI, Medline Plus notes.
Treatment
Cushing's disease treatment primarily involves surgery. A surgical method called transsphenoidal surgery extracts the pituitary tumor through the nasal canal\ via an incision placed above the teeth and through the sphenoid bone. If tumor size prevents surgery, radiation therapy can be used to decrease the tumor. Chemotherapy targets tumors that have spread, and medications used to control cortisol production include ketoconazole, mitotane, aminoglutethimide and metyrapone, according to the National Endocrine and Metabolic Diseases Information Service.
Prognosis
Surgical removal of the tumor can be successful and symptoms cured. However, a possibility remains that the tumor will return. If left untreated, Cushing's disease leads to sever illness and death, according to Medline Plus.
