@entity699 is uncommon in childhood. It is usually caused by the oversecretion of adrenocorticotrophic hormone (ACTH) by a @entity21422 . @entity922 is often undetected for long periods of time. The principal clinical features are @entity851 and @entity28 . We present four @entity1 who were diagnosed with @entity699 in a tertiary hospital from January 1995 to December 2002. There were two @entity1 and two @entity1 , aged 10-15 years. The main clinical features at presentation were growth failure and excessive @entity1017 . The interval between onset of symptoms and diagnosis ranged from 2.5 to 5 years. All @entity1 presented moon face and increased fat around the neck. In all @entity1 , 24-hour urinary free @entity701 was high and loss of normal serum @entity701 circadian rhythm (3/3) and suppression of @entity701 to less than 50 % of the basal level with high-dose but not with low-dose @entity619 (2/2) were observed. @entity4611 was detected by magnetic resonance imaging in three @entity1 ; no @entity5 was detected in the fourth @entity1 and inferior petrosal sinus sampling was performed, showing left lateralization of ACTH central secretion. Therapy consisted of transsphenoidal surgery in all @entity1 . Two @entity1 are in remission, one @entity1 presented disease recurrence requiring @entity5 could not be completely removed and one @entity1 had persistent disease after a second intervention and required pituitary radiotherapy. Two @entity1 showed @entity7961 after therapy.

[Diagnosis, treatment and long-term outcome in XXXX ].

@entity1 :: ('9606', 'Species') :: ['patients', 'patient', 'girls', 'boys'] @entity851 :: ('MESH:D006130', 'Disease') :: ['growth retardation'] @entity21422 :: ('MESH:D049913', 'Disease') :: ['pituitary corticotroph adenoma'] @entity28 :: ('MESH:D009765', 'Disease') :: ['obesity'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumor', 'total hypophysectomy because the tumor'] @entity699 :: ('MESH:D003480', 'Disease') :: ["Cushing's disease"] @entity4611 :: ('MESH:D010900', 'Disease') :: ['Pituitary microadenoma'] @entity619 :: ('MESH:D003907', 'Chemical') :: ['dexamethasone'] @entity1017 :: ('MESH:D015430', 'Disease') :: ['weight gain'] @entity701 :: ('MESH:D006854', 'Chemical') :: ['cortisol'] @entity7961 :: ('MESH:C580003', 'Disease') :: ['pituitary hormone deficiency'] @entity922 :: ('MESH:D013568', 'Disease') :: ['Clinical abnormality']
@entity699 :: (MESH:D003480,Disease) :: ['Cushing's disease']
