{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T14:20:19Z","timestamp":1783088419822,"version":"3.54.6"},"reference-count":14,"publisher":"The Endocrine Society","issue":"7","license":[{"start":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T00:00:00Z","timestamp":1779667200000},"content-version":"vor","delay-in-days":5,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,20]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Cushing disease (CD) secondary to adrenocorticotropin (ACTH)-secreting pituitary macroadenomas is uncommon, accounting for 10% to 15% of cases. We describe 3 patients from South Africa who presented with overt clinical features of hypercortisolism and considerable systemic complications, including hypertension, diabetes mellitus, and osteoporosis. Biochemical testing confirmed ACTH-dependent hypercortisolism with hypopituitarism and mild hyperprolactinemia consistent with stalk effect. Magnetic resonance imaging demonstrated pituitary macroadenomas, measuring 10\u2005mm or greater, with parasellar extension. Mass effect was observed in 1 patient resulting in cranial nerve III palsy, while the others had visual field deficits secondary to optic chiasm compression. All patients underwent endoscopic transsphenoidal surgery, with 1 achieving remission and 2 developing recurrence. These cases highlight that ACTH-secreting macroadenomas can present with severe systemic disease and significant mass effect, and emphasize the importance of lifelong follow-up.<\/jats:p>","DOI":"10.1210\/jcemcr\/luag127","type":"journal-article","created":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T11:32:05Z","timestamp":1776166325000},"source":"Crossref","is-referenced-by-count":0,"title":["Adrenocorticotropin-secreting pituitary macroadenomas: expanding the clinical spectrum"],"prefix":"10.1210","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-6504-2792","authenticated-orcid":false,"given":"Caitlin","family":"Iyer","sequence":"first","affiliation":[{"name":"Division of Endocrinology, Department of Medicine, Faculty of Medicine and Health Sciences, Tygerberg Hospital and Stellenbosch University , Cape Town 7505 ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Havenga","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Medicine, Faculty of Medicine and Health Sciences, Tygerberg Hospital and Stellenbosch University , Cape Town 7505 ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Roytowski","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Faculty of Medicine and Health Sciences, Tygerberg Hospital and Stellenbosch University , Cape Town 7505 ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Razaan","family":"Davis","sequence":"additional","affiliation":[{"name":"Division of Radiodiagnosis, Department of Medical Imaging and Clinical Oncology, Faculty of Medicine and Health Sciences, Stellenbosch University , Cape Town 7505 ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Zaharie","sequence":"additional","affiliation":[{"name":"Division of Anatomical Pathology, Department of Pathology, National Health Laboratory Services, Tygerberg Hospital and Stellenbosch University , Cape Town 7505 ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marli","family":"Conradie-Smit","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Medicine, Faculty of Medicine and Health Sciences, Tygerberg Hospital and Stellenbosch University , Cape Town 7505 ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2026,5,25]]},"reference":[{"issue":"2","key":"2026070309311256200_luag127-B1","doi-asserted-by":"crossref","first-page":"404","DOI":"10.3171\/2016.1.JNS152119","article-title":"Cushing\u2019s disease: pathobiology, diagnosis, and 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