Cushing Syndrome During Pregnancy: New Diagnostic Methods Used in Three Cases of Adrenal Cortex Carcinoma

Cushing's syndrome during pregnancy, often caused by an adrenal cortical tumor, was a rare condition with poor outcomes for both mother and fetus. In this study, 3 cases of adrenal cortex carcinoma were diagnosed during pregnancy, revealed by local tumor signs or pulmonary embolism. The clinical features of hypercortisolism, such as moderate hair growth, weight gain, and high blood pressure, were initially misattributed to pregnancy. Diagnosis was confirmed by significantly elevated urinary and salivary cortisol levels compared to normal pregnancy values, and high salivary testosterone levels. Magnetic resonance imaging identified unilateral adrenal masses. These cases highlighted the challenges in diagnosing hypercortisolism during pregnancy and emphasized the importance of assessing unbound steroids and using MRI for early detection to prevent severe complications.