The Internal Wildlife of Hypercortisolism: Cushing’s Syndrome

Cushing's syndrome is a complex endocrine disorder resulting from prolonged exposure to excessive cortisol. It may arise from endogenous causes such as pituitary adenomas, adrenal tumors, or ectopic ACTH secretion, or from exogenous administration of glucocorticoids. The syndrome presents with characteristic clinical features including central obesity, moon face, purple striae, hypertension, hyperglycemia, osteoporosis, muscle weakness, and psychiatric disturbances.

This chapter explores the etiology, pathophysiology, diagnostic evaluation, and current treatment approaches for Cushing’s syndrome. Diagnostic methods include hormonal testing, imaging studies, and differential evaluation of ACTH-dependent and ACTH-independent causes. Management focuses primarily on surgical removal of the underlying lesion, with medical therapy and radiotherapy serving as adjunctive options.