Questionnaires and Medical Record Review in Studying Treatment Outcomes in Patients with Cushing Syndrome

Inclusion Criteria

• Age 14 or older
• Active or treated overt Cushing’s (due to pituitary, ectopic, or adrenal tumor), mild adrenal Cushing’s syndrome (MACS), or a silent corticotroph tumor
• The diagnosis of CS or MACS will be made by the principal investigator (PI), based on the below Endocrine Society and European Society of Endocrinology guidelines, the patient’s clinical presentation, and the PI’s judgement * Diagnostic criteria for ACTH-dependent Cushing’s are according to the Endocrine Society guidelines and include: elevated 24-hour urinary free cortisol (UFC), normal or elevated plasma adrenocorticotropic hormone (ACTH), elevated midnight salivary cortisol levels, or classic dexamethasone suppression testing for CD (morning cortisol > 5 ug/dL after 1 mg overnight or classic 2-day low dose test) and a pituitary lesion on magnetic resonance imaging (MRI) (in the case of pituitary Cushing’s); if patient does not have any of these results, pathology of ACTH tumor may confirm presence of disease * Diagnostic criterion for MACS is according to the European Society of Endocrinology guidelines: Classic dexamethasone suppression testing for CD (morning cortisol >1.8 µg/dL after 1 mg overnight) and the presence of an adrenal adenoma
• Silent corticotroph tumors will be defined by surgical pathology demonstrating positivity for ACTH, in the absence of clinical and biochemical features of Cushing’s syndrome
• In lieu of MRI, surgical, or laboratory reports, physician's assessment note including mention of results will also be used as source for eligibility purposes

Exclusion Criteria

• Patients with a diagnosis of iatrogenic Cushing’s