Mediastinal Widening in Iatrogenic Cushing's Syndrome
Authors: STEPHEN F. BODMAN
Journal: Annals of Internal Medicine (1967)

Case Studies1 August 1967Mediastinal Widening in Iatrogenic Cushing's SyndromeSTEPHEN F. BODMAN, M.D., JOHN J. CONDEMI, M.D.STEPHEN F. BODMAN, M.D.Search for more papers by this author, JOHN J. CONDEMI, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-67-2-399 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptExcesses in both endogenous and exogenous adrenal corticosteroids result in the readily recognized clinical syndrome initially described by Cushing (1). An outstanding feature is the characteristic body habitus, a manifestation of central deposition of fat and loss of muscle mass. The basis for the central deposition of fat in the face, neck, and trunk under the influence of excess corticosteroids is not understood (2). This process also seems to be responsible for the recently described fatty episternal "dewlap" tumor developing in three patients receiving corticosteroids (3). While much emphasis has been placed on the changes in personal appearance, little emphasis...References1. CUSHING H: The basophil adenomas of the pituitary body and their clinical manifestations. Bull. Hopkins Hosp. 50: 137, 1932. Google Scholar2. GOODMANGILMAN LSA: The Pharmacological Basis of Therapeutics, 3rd ed. The Macmillan Co., New York, 1965, p. 1619. Google Scholar3. LUCENABENNETTPIERRE GEWMRV: "Dewlap." A corticosteroid-induced tumor. New Eng. J. Med. 275: 834, 1966. CrossrefMedlineGoogle Scholar4. KOERNERSUN HJDI: Mediastinal lipomatosis secondary to steroid therapy. Amer. J. Roentgen. 98: 461, 1966. CrossrefGoogle Scholar5. CICCIARELLISOULEMCGOON FEEHDC: Lipoma and liposarcoma of the mediastinum: a report of 14 tumors including one lipoma of the thymus. J. Thorac. Cardiov. Surg. 47: 411, 1964. CrossrefMedlineGoogle Scholar6. PACHTERLATTES MRR: Mesenchymal tumors of the mediastinum. I. Tumors of fibrous tissue, adipose tissue, smooth muscle, and striated muscle. Cancer 16: 74, 1963. CrossrefMedlineGoogle Scholar7. HODGEAPONTEMCLAUGHLIN JGE: Primary mediastinal tumors. J. Thorac. Cardiov. Surg. 37: 730, 1959. Google Scholar8. LYONSCALVYSAMMONS HAGLBP: The diagnosis and classification of mediastinal masses. A study of 782 cases. Ann. Intern. Med. 51: 897, 1959. LinkGoogle Scholar9. BURNETTROSEMONDBACHER WEGPRM: The diagnosis of mediastinal tumors. Surg. Clin. N. Amer. 32: 1673, 1952. CrossrefGoogle Scholar10. LEROUX BT: Cysts and tumors of the mediastinum. Surg. Gynec. Obstet. 115: 695, 1962. MedlineGoogle Scholar11. KEELYVANA JLAJ: Lipomas of the mediastinum. Surg. Gynec. Obstet. 103: 313, 1956. Google Scholar12. JOANNIDESLANGSTON MHT: Mediastinal tumors and cysts in the adult. Dis. Chest 38: 243, 1960. CrossrefMedlineGoogle Scholar13. NIELSENDRIVSHOLMFISCHERBROCHNER-MORTENSEN JBAAFK: Long-term treatment with corticosteroids in rheumatoid arthritis (over period of 9 to 12 years). Acta Med. Scand. 173: 177, 1963. CrossrefMedlineGoogle Scholar14. THORNJENKINSLAIDLAWGOETZDINGMANARONSSTREETENMCCRACKEN AWDJCFCJWLDHBH: Medical progress: pharmacologic aspects of adrenocortical steroids and ACTH in man. New Eng. J. Med. 248: 233, 284, 323, 444, 588, 632, 1953. CrossrefGoogle Scholar15. PLOTZKNOWLTONRAGAN CMAIC: The natural history of Cushing's syndrome. Amer. J. Med. 15: 597, 1952. CrossrefGoogle Scholar16. WILLIAM RH (editor): Textbook of Endocrinology. W. B. Saunders Co., Philadelphia, 1962, p. 346. Google Scholar17. SOFFERIANNACCONEGABRILOVE LJAJL: Cushing's syndrome: a study of fifty patients. Amer. J. Med. 30: 129, 1961. CrossrefGoogle Scholar18. BUNIMZIFFMCEWEN JJMC: Evaluation of prolonged cortisone therapy in rheumatoid arthritis: four-year study. Amer. J. Med. 18: 27, 1955. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Rochester, New YorkFrom the Allergy Service, Department of Medicine, Strong Memorial Hospital, University of Rochester, School of Medicine and Dentistry, Rochester, N. Y.This study was supported in part by training grant 5 T1 A1-28-10, U. S. Public Health Service, Washington, D. C.This paper was presented in part at the 23rd Annual Meeting of the American Academy of Allergy, February 21, 1967, Palm Springs, Calif.Requests for reprints should be addressed to John J. Condemi, M.D., Department of Medicine, Strong Memorial Hospital, Rochester, N. Y. 14620. 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