Six decades of clinical use, accompanied by number of prospective and retrospective studies, have established metyrapone as an effective treatment for Cushing's syndrome. What new information will you glean from this helpful, question and answer format, review?

This review explains the recent work of Walia et al. 2021, who have used a novel imaging technique to correctly identify adenomas, some of which were negative on MRI or of ectopic origin. Could this study eventually change how we diagnose CD?

This novel, non-invasive molecular imaging technique potentially expands current diagnostic capabilities – will you investigate?

Findings from this literature review suggest using a stepwise approach to performing IPSS and interpreting the results. How might your practice be influenced?

This study attempts to establish a causal relationship between hypercortisolism and AF but what were the precise findings and likely mediators?

This study evaluated psychiatric and neurocognitive functions in adrenal incidentaloma patients with subclinical hypercortisolism. What recommendations can be made?

Mutations in the ATRX gene have been implicated in the development of several cancer types. This study examined the ATRX gene in APTs and PCs – what were the findings, and could new techniques identify patients at high risk?

This study measured hair cortisol and cortisone in a variety of patients with Cushing's syndrome. Are these measurements of diagnostic value in patients with mild disease?

While full blood count and serum inflammation-based scores reflect systemic inflammation and predict outcomes in cancer, are these biochemical data of similar value in the treatment of pituitary adenomas?

Current medical therapies for CD by and large exert no action on tumour growth – could this be about to change?

While there is still no specific medical treatment for Carney complex, what advances have been made in our understanding of this disorder and what recommendations can be made?

The adverse effects of chronic exposure to hypercortisolism on the human brain remain unclear.  This study correlated MRI findings with neuropsychological testing and clinical examination in 97 active and remitted CS patients. What was learned?

This study looked at individual Insulin-like growth factor I concentrations 6 months after curative surgery for Cushing's syndrome. What were the correlations with adverse long-term myopathy outcomes?

This longitudinal cohort study examined the SMRs of 191 CD patients initially presenting with pituitary adenoma. What were the independent risk factors related to increased mortality in this group?

This study compared the in vitro effects of racemic ketoconazole with levoketoconazole on adrenocortical and pituitary adenoma cells. What effects were seen?

Results of this study suggests a close association between chromosome instability and aggressive corticotroph tumour behaviour. Could these findings lead to the identification of high-risk tumours and, in turn, a new system of classification?

Experts from the USA, Canada and Austria explore the risk assessment and management of severe complications of Cushing’s disease. What will you learn from this case-based guide?

This single-center retrospective cohort study examined the records of 123 adult patients seen between 1985 and 2018. What biochemical correlations were found and what degree of thyroid function was restored after successful treatment of Cushing’s syndrome?

Can you predict the likelihood of younger patients remaining overweight or obese following successful treatment and what, if anything, can be done to intervene?

What is the impact of levoketoconazole treatment on quality-of-life scores, depression, and specific clinical signs and symptoms characteristic of CS?

This paper describes a diagnostic algorithm for cyclic CS with special regard to hair cortisol analysis and the desmopressin stimulation test – could this tool facilitate faster diagnosis?

This systematic review examines the presence and severity of neuropsychological impairment in Cushing’s patients. What reassurance can be given to patients and what studies remain to be done?

This review article summarizes our current understanding of this rare disorder and includes definitions, pathology, and treatment options, together with a subset of tumors undergoing malignant transformation.

A total of 12 pregnant women who underwent adrenalectomy over a 15-year period were identified from a prospectively maintained database. Results show that while maternal outcome is acceptable, fetal outcome is influenced by several factors and is variable.

This is a retrospective case record analysis of 42 patients with Cushing’s Disease who underwent conventional fractionated radiotherapy (CFR) with at least 12 months follow-up. Results show that peri-CRT use of cabergoline is significantly associated with increased recurrence rates of disease.

This study pooled data from 255 patients across 10 institutions participating in the International Radiosurgery Research Foundation. Are endocrine remission rates most improved following early or late stereotactic radiosurgery?

This multicentre retrospective study of 95 patients with Cushing’s Disease, responding preoperatively to desmopressin test (DT) and with early post-operative corticotropic insufficiency (COI), underwent a DT within 3 months post-surgery. Results may help stratify patients with COI and refine their follow-up according to the risk of recurrence.

This study aimed to establish robust reference intervals for, and compare the diagnostic accuracy of, salivary cortisol and cortisone in late-night samples and after a low-dose dexamethasone suppression test. Will the results confirm the accuracy of late-night cortisol and cortisone testing?

This tertiary care center study, which looked at 43 patients over a 35-year period, analyzed clinical symptomatology, cortisol, ACTH, and radiology following total bilateral adrenalectomy. Could the findings lead to improved patient care, including a reduction in the need for frequent imaging?

This study of fourteen patients − with severe and complicated Cushing’s syndrome related to adrenal carcinoma or ectopic ACTH secretion − compared data from those treated with high starting doses of etomidate in ICU or with lower starting doses in non-ICU medical wards. Results suggest that low doses of etomidate in medical wards should be considered.

Primary pigmented nodular adrenocortical disease (PPNAD) and primary bilateral macronodular adrenocortical hyperplasia are linked to respective gene mutations. This study aims to determine the potential influence of ARMC5 genes – which have many non-pathological variants in the general population – on PRKAR1A mutations, the defect that causes PPNAD.  What was shown?

This review identified 91 articles, which included original articles, case reports and case series, reporting on 99 cases of ectopic adrenocorticotropic hormone and/or corticotrophin-releasing-hormone secreting pheochromocytomas. What do we currently know about disease characteristics, management, and outcomes in these patients?

Read the findings of the prospective, multicentre, open-label, double-blind randomized withdrawal period phase III study (LINC 3).

This cross-sectional study of 200 patients took place in a referral University Hospital Center from 2010 to 2019.  The human corticotropin-releasing hormone (CRH) test was performed mainly for the differential diagnosis of ACTH-dependent CS or adrenal lesions but what were the findings?

This study of 64 patients confirms earlier findings that tumor-to-liver standardized uptake value ratio (SUV)_max (>1.5) is a useful biomarker for the diagnosis of malignancy in adrenal masses but was a predictive model also identified?

This study was designed to identify predictive features of delayed post-operative disease remission using machine-based algorithms. Findings, which were based on 201 patients, identified a model with predictive ability that was significantly better than using Knosp grading and postoperative immediate morning serum cortisol alone. Could this effective approach lead to better patient care?

This case study highlights the importance of monitoring ACTH and corticotroph tumor size in patients with persistent Cushing’s syndrome, either under effective treatment with steroidogenesis inhibitors or after bilateral adrenalectomy.

This retrospective cohort study identified 1199 new adrenal Cushing’s syndrome patients presenting between 2002 and 2017. Results show a high risk of pre- and post-operative comorbidities. The major types of glucocorticoids prescribed are given.

Patients with ACTH-dependent Cushing's syndrome (n = 27) underwent 68-Ga CRH PET-CT. Information provided by medical imaging provided surgeons with valuable information for intraoperative tumor navigation, and helped in differentiating pituitary from extra-pituitary sources of ACTH-dependent CS.

Postoperative day 1 morning serum cortisol value is shown to be a helpful predictor of long-term disease recurrence in the statistical analysis of 260 patients with Cushing’s disease.

This longitudinal cohort study of patients with Cushing’s disease (1979−2018) identified the main predictors for mortality, which is mainly linked to cardiovascular disease.

This retrospective cohort study of 73 pediatric patients with Cushing’s disease analyzed BMI after long-term remission and determined predictive factors for those at risk of remaining overweight or obese following successful treatment.

This review article examines the use of adrenally acting medical therapies, including ketoconazole, metyrapone, osilodrostat, mitotane, and etomidate. Use of these drugs mandates adequate patient instruction and close monitoring to that ensure treatment goals are met while untoward adverse effects are minimized.

This cross-sectional study at a tertiary referral center examines 36 women in disease remission. The study aims to quantify the degree of fatty infiltration in thigh muscle and evaluate the relationship between these changes and physical performance.

This cross-sectional study with prospective enrolment (2014− 2019), involved 213 patients with adrenal adenomas, with and without Cushing’s syndrome. Bone turnover markers within three patient subgroups are discussed, together with the impact of adrenalectomy.