{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T16:40:03Z","timestamp":1742229603247,"version":"3.38.0"},"reference-count":14,"publisher":"PAGEPress Publications","issue":"1","license":[{"start":{"date-parts":[[2025,2,11]],"date-time":"2025-02-11T00:00:00Z","timestamp":1739232000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatr Med Chir"],"abstract":"<jats:p>Cushing\u2019s Disease (CD), defined as hypercortisolism caused by excess Adrenocorticotropic Hormone (ACTH) secretion by a pituitary corticotroph adenoma, rarely presents in the pediatric age range. The aim is to describe a 12-year-old Albanian boy with a challenging pathway to diagnosis and treatment process for CD. He presented with headaches, rapid weight gain during the last three years, stunting, increased body hair growth, and a typical Cushingoid appearance. After a consultation in the Pediatric Endocrinology Unit at the University Hospital Center, \u201cMother Teresa,\u201d in Tirana, the boy was pre-diagnosed with CD, and hypophyseal adenoma was suspected due to suggestive laboratory tests, although non-consistent imaging results. An ectopic ACTH-dependent Cushing syndrome was suspected together with neuroendocrine neoplasia (carcinoid tumor) as a thoracic CT showed a nodular lesion with regular-lobulated sharp contours in the lower lobe of the right lobe resulted in pulmonary tuberculosis granuloma. Even imaging failed to identify the ACTHsecreting microadenoma; the decisive examination was an intervention to collect samples from the inferior petrosal sinus during the CRH test, which found a left-side ACTH-secreting focus. Left hemi-hypophysectomy was performed using gamma knife therapy, resulting in effective normalization of hypercortisolism, but with the side effect of growth hormone deficiency.<\/jats:p>","DOI":"10.4081\/pmc.2025.340","type":"journal-article","created":{"date-parts":[[2025,2,11]],"date-time":"2025-02-11T10:45:30Z","timestamp":1739270730000},"source":"Crossref","is-referenced-by-count":0,"title":["Challenges in diagnosis and treatment of Cushing disease in a 12-year-old boy"],"prefix":"10.4081","volume":"47","author":[{"given":"Agim","family":"Gjikopulli","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sonila","family":"Tomori","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marjeta","family":"Tanka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Donjeta","family":"Bali","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2549","published-online":{"date-parts":[[2025,2,11]]},"reference":[{"key":"3350","doi-asserted-by":"publisher","DOI":"10.1007\/BF03343985"},{"key":"3351","doi-asserted-by":"publisher","DOI":"10.1016\/j.tem.2007.03.005"},{"key":"3352","doi-asserted-by":"publisher","DOI":"10.1007\/s11102-019-00951-1"},{"key":"3353","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.1995.tb01888.x"},{"key":"3354","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199409083311002"},{"key":"3355","unstructured":"6. Fahlbusch R. Neurosurgical management of Cushing\u2019s disease in children. In: Savage MO, Bourguignon JP,Grossman AB, eds. Frontiers of Paediatr Neuroendocrinol. Oxford: Blackwell Scientific Publications; 1994: pp. 68\u201372."},{"key":"3356","doi-asserted-by":"publisher","DOI":"10.1210\/edrv.19.5.0346"},{"key":"3357","doi-asserted-by":"publisher","DOI":"10.1530\/eje.1.01921"},{"key":"3358","doi-asserted-by":"publisher","DOI":"10.1159\/000088587"},{"key":"3359","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2021.720823"},{"key":"3360","doi-asserted-by":"publisher","DOI":"10.1159\/000091830"},{"key":"3361","doi-asserted-by":"publisher","DOI":"10.3171\/ped.2005.103.5.0413"},{"key":"3362","doi-asserted-by":"publisher","DOI":"10.1227\/01.NEU.0000166580.94215.53"},{"key":"3363","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2003-030871"}],"container-title":["La Pediatria Medica e Chirurgica"],"original-title":[],"link":[{"URL":"https:\/\/www.pediatrmedchir.org\/pmc\/article\/download\/340\/393","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.pediatrmedchir.org\/pmc\/article\/download\/340\/394","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.pediatrmedchir.org\/pmc\/article\/download\/340\/393","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T16:23:11Z","timestamp":1742228591000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.pediatrmedchir.org\/pmc\/article\/view\/340"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,11]]},"references-count":14,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,1,22]]}},"URL":"https:\/\/doi.org\/10.4081\/pmc.2025.340","relation":{},"ISSN":["2420-7748","0391-5387"],"issn-type":[{"type":"electronic","value":"2420-7748"},{"type":"print","value":"0391-5387"}],"subject":[],"published":{"date-parts":[[2025,2,11]]}}}