Subclinical cushing’s disease: presentation of three cases and critical review

Unlike subclinical Cushing’s disease, adrenal subclinical Cushing’s syndrome is widely recognized. It is defined as an autonomous cortisol hyperproduction of mild intensity not causing specific clinical signs, but detectable biochemically as derangements of the hypothalamic-pituitary-adrenal axis function. Although Cushing’s disease accounts for the majority of hypercortisolism states, subclinical Cushing’s disease has been rarely reported. Three cases of subclinical Cushing’s disease due to pituitary corticotrophic macroadenomas, confirmed by immunohistochemistry, are presented in order to underscore its recognition by clinical endocrinologists and to emphasize a diagnostic evaluation of hypercortisolism in all cases of pituitary adenomas.

Subclinical Cushing’s syndrome; Subclinical Cushing’s disease; Corticotrophic macroadenoma; Pituitary tumor; Immunohistochemistry