P-50 We Know You Are There: Missing Mass
January 2025
in “
JCEM Case Reports
”
Studysummary In this case report, researchers described a patient with Cushing's Disease exhibiting no detectable mass, where Metyrapone therapy was effectively used to manage symptoms, suggesting a treatment option for similar diagnostic challenges. Our plain-language summary of this paper — not a Tressless recommendation.
This case study discusses a 40-year-old female patient with Cushing's Disease (CD) where the causative mass could not be identified through imaging. Despite having symptoms like male-pattern hair loss, abdominal obesity, and elevated cortisol levels, pituitary MRI and abdominal CT scans showed no mass lesions. The patient had a complex medical history, including bipolar disorder, type 2 diabetes, and hypertriglyceridemia, which were managed with various medications and lifestyle changes. Intravenous Desmopressin stimulation test confirmed CD, and treatment with Metyrapone was initiated, leading to significant improvements in her condition, including weight loss and reduced triglyceride levels. This case highlights Metyrapone as a viable treatment option for CD when the mass is undetectable.
