• Ty B Carroll and James W Findling.
• Endocrinology Center, Medical College of Wisconsin, W129 N7055 Northfield Drive, Building A, Suite 203, Menomonee Falls, WI 53051, USA. tcarroll@mcw.edu
• Curr Opin Endocrinol Diabetes Obes. 2009 Aug 1;16(4):308-15.

Purpose Of ReviewCushing's syndrome is being recognized with greater frequency and in patients with milder disease. Many of these individuals have nonpituitary causes of their hypercortisolism. This review discusses the classification, presentation, diagnosis, and therapy of patients with Cushing's syndrome from nonpituitary causes.Recent FindingsMany previously unrecognized or poorly understood causes of Cushing's syndrome have been elucidated. It is now appreciated that essentially any form of exogenous glucocorticoid is capable of causing Cushing's syndrome. Additionally, new findings have led to a more complete understanding of bilateral nodular adrenal disease.SummaryThe diagnosis of patients with less profound cortisol excess has increased the prevalence of Cushing's syndrome and made nonpituitary causes more common. As a result, clinicians must be cognizant of such patients and pursue the diagnosis when appropriate.

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