ACTH-producing hypophyseal carcinoma monitored by computed tomography.

A case of malignant ACTH-producing hypophyseal tumor with serial CT scan and histological investigation is discussed. The neoplasm became evident with a Cushing's syndrome and was treated with adrenalectomy and radiotherapy. Nelson's syndrome subsequently developed due to histologically atypical adenoma. Subarachnoid metastases occurred after 4 years, finally causing a fatal intracranial hemorrhage.