NORCHOLESTEROL-I-131 SPECT SCINTIGRAPHY OF THE ADRENAL-CORTEX IN THE DIAGNOSIS OF A CUSHING-SYNDROME WITH TRANSITION FROM PITUITARY TO ADRENAL ORIGIN

The case of a 49 yr old alcoholic woman with clinical and laboratory f indings that suggested a Gushing syndrome is presented. The functional tests showed cortisol suppression greater than 50% of the basal value with 8 mg of dexamethasone and no response in the combined dexamethas one/desmopressin test. Pituitary Nuclear Magnetic Resonance (NMR) was negative, Abdominal Computed Axial Tomography suggested hyperplastic a drenal glands; adrenal nodules were not found in the NMR. Pituitary or hipothalamic Cushing with secondary, autonomous micronodular adrenal hyperplasia was suspected. Norcholesterol-I-131 SPECT scintigraphy und er dexamethasone suppression demonstrated a functional adrenal hyperpl asia which was hystologically confirmed.