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Determining the cause of spontaneous Cushing’s syndrome is essential so that appropriate therapy can be recommended. Most patients (80%) have an ACTH-secreting neoplasm (pituitary or ectopic), while the rest have an adrenal-dependent (ACTH-independent) etiology. After hypercortisolism has been convincingly established, plasma adrenocorticotropic hormone (ACTH) levels are obtained to subdivide Cushing’s...
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