Brief Answer:
Hello

Detailed Answer:
Hello,
Good day.

There are possibiities of a recurrence of cushings syndrome

. I have seen 5 patients with recurrent cushing's syndrome. ( 4 was recurrence due to regrowth of pituitary nodule, where as the other one was due to re apperance of cortisol producing nodule in the other adrenal). Recurrence is common in pituitary cushings where as it is rare in adrenal cushings.

In your case, you had one adrenal gland along with the tumour was removed several years ago. If you have symptoms of cushing's syndrome ( tiredness, proximal muscle weakness, low serum potasium, resistant hypertension or diabetes, recurrent skin infections, excess hair growth over ody , new pinkish striae/stretch marks in abdomen etc).

Cushing's syndrome due to genetic causes can recur in other adrenal gland later in life. You should approach the old hospital where the firts surgery was done and try to get a copy of the biospy report of firts surgery.

Even though the urine test is sensitive to pick up Cushing's, there are 5-6% chances of it missing the diagnosis. In that case , if we have a strong suspicion, we do a second test like a dexamethasone suppression test or a salivary cortisol test.

In a rare situation, there can be intermittent secretion of excess cortisol which is called as Cyclical cushings and yet another entity exists called as subclinical cushings. This is extremly difficult to diagnose and several salivary cortisol samples may be necessary.

However, several other diseases can mimic cushing's syndrome ( Depression, alcoholism, obesity etc). This is an important differential diagnosis and need to be rule out as well.
you should consult an endocrinologist rather than an Internist. An expert endocrinologist will be able to guide you further.

Regards
Binu

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