Pituitary-dependent Cushing disease and primary adrenocortical nodular dysplasia in childhood. Presentation of 4 cases.

Four patients with Cushing syndrome were followed for 1.5-12 years. The main clinical symptoms were marked growth retardation and truncal obesity. Two patients had pituitary-dependent Cushing disease, while the other two had primary adrenocortical nodular dysplasia. The treatment of choice of pituitary-dependent Cushing disease is transsphenoidal resection of the microadenoma while in primary adrenocortical nodular dysplasia bilateral adrenalectomy with subsequent steroid replacement is recommended. In our pre- or early pubertal patients catch-up growth occurred following surgical therapy and in all cases pubertal development proceeded normally.