A CASE OF CUSHINGS-DISEASE ACCOMPANIED BY RATHKES CLEFT CYST - THE USEFULNESS OF CAVERNOUS SINUS SAMPLING IN THE LOCALIZATION OF MICROADENOMA

A 42-year-old man presented with classical symptoms of Cushing's disea se. Endocrinological examinations indicated the presence of a adrenoco rticotropin-(ACTH) producing pituitary adenoma. Magnetic resonance ima ging showed a cystic sellar lesion, which had features of a Rathke's c left cyst, whereas the adenoma was not depicted. The ratio of blood AC TH concentration between cubital vein, left, and right cavernous sinus nas 1: 1.4: 20. During transsphenoidal surgery, in addition to the Ra thke's left cyst, a tiny adenoma was detected beneath the left pituita ry lobe. Cavernous sinus sampling is a useful auxiliary in the localiz ation of an ACTH-producing adenoma, as in this case.