[Cushing's syndrome 1985: current views and possibilities].

According to the current view a semiautonomously ACTH-producing pituitary microadenoma is the true cause of pituitary-dependent Cushing's syndrome in most instances. Only exceptionally does the disease seem to be caused by a functional pituitary or hypothalamic disturbance of cortisol regulation. A newly discovered rare etiology is ectopic production of CRF. Cushing's syndrome is still most reliably diagnosed by abnormal adrenocortical function tests based on corticosteroid determinations. However, determination of plasma ACTH concentrations and computer-assisted tomography of the pituitary or adrenal glands have become useful tools in differentiating the various forms of Cushing's syndrome. Although a considerable number of available drugs provide effective chemotherapy for Cushing's syndrome, surgical elimination of ACTH-producing or cortisol-producing tumors is still the therapy of choice in most cases.