Cushing syndrome in a young woman due to primary pigmented nodular adrenal disease

Abstract

Objective: To report a case of Cushing syndrome due to apparently sporadic primary pigmented nodular adrenal disease in a young woman. Methods: We describe the clinical, biochemical, radiologic, and histologic findings of Cushing syndrome due to the rare condition of primary pigmented nodular adrenal disease. Results: A 30-year-old woman presented with a 2-year history of worsening itch without rash over her shoulders and arms and weight gain, particularly around the abdomen and face. Careful questioning did not elicit any history of exogenous glucocorticoid use (systemic or topical), including hydrocortisone. On examination, the patient had a slightly rounded and plethoric face, a small buf..