What are Corticotroph adenomas – Cushing’s disease

Corticotroph adenoma is a tumour of the pituitary gland that secretes excess adrenocorticotropic hormone (ACTH) and causes Cushing’s disease.


What is Cushing’s disease?

Cushing’s disease is a rare condition caused by hypersecretion of the adrenocorticotropic hormone (ACTH) from the pituitary gland leading to increased secretion of cortisol by the adrenal glands. Increased levels of cortisol in the blood (hypercortisolaemia) have systemic consequences as they cause complications from various organs of the body. Severe hypercortisolaemia can be life-threatening.


How common is it?

Corticotroph adenomas occur less frequently (2%) and their incidence is 0.17 per 100,000.


What are the symptoms and signs?

The clinical syndrome that Cushing’s disease manifests with, includes symptoms and signs such as:

  • Abdominal obesity
  • Facial roundness (moon face)
  • fat accumulation at the base of the neck (buffalo hump)
  • hypertension
  • acne
  • bruising
  • stretch marks (purple striae)
  • psychiatric manifestations (anxiety, depression)
  • menstrual disorders
  • osteopenia, osteoporosis

How is Cushing’s disease diagnosed?

Cushing’s disease is diagnosed by a series of blood tests and imaging studies. Endocrine dynamic tests play a predominant role in documentation of hypercortisolaemia. Often the diagnosis of the disease can be quite difficult, so experience and a specialised centre are required.


How is Cushing’s disease treated?

The treatment of choice for Cushing’s disease/corticotroph adenoma is transsphenoidal microadenomectomy. However, sometimes radiotherapy, pharmacotherapy or combinations of the above may be needed.