case_images: PMC7603813_01
case_images: face picture before (A) and one year after surgery (B)
case_images: PAMJ-36-315-g001.jpg
case_images: PMC7603813_01_PAMJ-36-315-g001.jpg
case_images: F1
case_images: A and synaptophysin. After surgical removal, we noted a complete response and the patient has adrenal insufficiency over two years (Table 1, Figure 1B, Figure 2B, Figure 3B).
case_images: flanks pictures before (A) and one year after surgery (B), showing purple striae
case_images: PAMJ-36-315-g002.jpg
case_images: PMC7603813_01_PAMJ-36-315-g002.jpg
case_images: F2
case_images: A and synaptophysin. After surgical removal, we noted a complete response and the patient has adrenal insufficiency over two years (Table 1, Figure 1B, Figure 2B, Figure 3B).
case_images: thighs pictures before (A) and one year after surgery (B), showing purple striae
case_images: PAMJ-36-315-g003.jpg
case_images: PMC7603813_01_PAMJ-36-315-g003.jpg
case_images: F3
case_images: Figure 3A). Following psychiatric evaluation, the patient was diagnosed with severe depression, suicidal ideation, and panic attacks. A and synaptophysin. After surgical removal, we noted a complete response and the patient has adrenal insufficiency over two years (Table 1, Figure 1B, Figure 2B, Figure 3B).
case_images: coronal chest MRI T2-weighted revealed one nodular defined lesion in the left lung (arrow)
case_images: PAMJ-36-315-g004.jpg
case_images: PMC7603813_01_PAMJ-36-315-g004.jpg
case_images: F4
case_images: Chest, abdomen, and pelvis CT scan reviewed to localize the source of ectopic cushings, revealed one nodular defined lesion (12mm) in the left lung and confirmed by MRI (Figure 4), normal adrenal glands (no signs of hyperplasia, enlargement, or nodules) and no other suspicious lesions.
case_images: axial chest MRI T2-weighted before (A) and one year after surgery (B) reveled buffalo neck (arrow 1 and 4) and vertebral compression fractures of D7 and D9 (arrow 2 and 3)
case_images: PAMJ-36-315-g005.jpg
case_images: PMC7603813_01_PAMJ-36-315-g005.jpg
case_images: F5
case_images: On the metaboic level, in addition to secondary diabetes and secondary mixed hyperlipidemia, the Bone assessment was in favor of osteporosis, Magnetic resonance imaging (MRI) shows osteoporotic vertebral compression fractures which explains dorsal spinal pain (Figure 5).