Ahmed Shaho F, Mahmood Sherzad W, Ismaeil Deari A, Baba Hiwa O, Salih Karzan M, Tahir Soran H, Kaka Ali Hemn H, Mohammed Rebaz O, Abdullah Swara H, Hama Ali Rekan K, Abdalla Berun A, Kakamad Fahmi H
Scientific Affairs Department, Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah 46001, Iraq.
Department of Medicine, Shar Hospital, Malik Mahmud Ring Road, Sulaymaniyah 46001, Iraq.
J Surg Case Rep. 2025 Jun 8;2025(6):rjaf366. doi: 10.1093/jscr/rjaf366. eCollection 2025 Jun.
Cushing's disease (CD), caused by an adrenocorticotropic hormone-secreting pituitary adenoma, is challenging to diagnose, especially in obese patients post-bariatric surgery. This report discusses a misdiagnosed case of CD in a 42-year-old obese male with hypertension. CD was suspected only after surgery, confirmed by magnetic resonance imaging (MRI) showing a pituitary macroadenoma. Despite transsphenoidal surgery and ketoconazole therapy, the patient suffered liver failure and died. Among 20 CD reviewed cases in the literature, 65% were misdiagnosed. MRI and immunohistochemistry confirmed tumors, with 55% achieving remission post-surgery. Screening for CD before bariatric surgery may prevent mismanagement and complications.
库欣病（CD）由分泌促肾上腺皮质激素的垂体腺瘤引起，诊断具有挑战性，尤其是在肥胖患者接受减重手术后。本报告讨论了一名42岁肥胖男性高血压患者CD误诊病例。仅在手术后才怀疑患有CD，磁共振成像（MRI）显示垂体大腺瘤，确诊了该病。尽管进行了经蝶窦手术和酮康唑治疗，该患者仍出现肝衰竭并死亡。在文献中回顾的20例CD病例中，65%被误诊。MRI和免疫组化确诊了肿瘤，55%的患者术后病情缓解。在减重手术前筛查CD可预防管理不当和并发症。
