Hypothalamo-pituitary and adrenocortical function were studied in 3 patients with Cushing's syndrome before and after removal of a unilateral adrenocortical adenoma. Postoperatively, the response in each patient to sustained ACTH stimulation and to intermittent ACTH stimulation for periods of 6 weeks to 1 year were studied. Both hypothalamo-pituitary and adrenocortical dysfunction were demonstrated in all, as evidenced by low basal urinary steroid excretion and abnormal responses to ACTH or to Su-4885 administration during the first 4–9 months postoperatively. These data indicate that adrenocortical atrophy of the corticogenic type is a complex lesion involving abnormalities of both the hypothalamo-pituitary axis and the adrenal cortex. The recurrence of Cushing's syndrome in one patient due to autonomous multinodular adrenal cortical hyperplasia in the remaining adrenal gland 4 years after unilateral adrenalectomy, we believe, represents the second example of this syndrome.
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Tucci et al. (1965) studied this question.