The 40-year-old woman shown below complains of weakness and amenorrhea. She has hypertension and diabetes mellitus. The clinical findings may be explained by: (A) Pituitary tumor, (B) Adrenal tumor, (C) Ectopic ACTH production, (D) Any of the above
Answer is D. (d) Source: (Braunwald, 15/e, pp 2091-2093.) The clinical findings all suggest an excess production of cortisol by the adrenal gland. Hypertension, truncal obesity, and abdominal striae are common physical findings. The process responsible for continued excess could be any of those listed--an ACTH-secreting pituitary tumor, an ectopic ACTH-producing neoplasm, or a primary adrenal tumor.