Endogenous hypercortisolism, known as Cushing’s syndrome (CS), is a chronic endo- crine disorder caused by excessive adrenal cortisol secretion, with an estimated inci- dence of 0.7 to 2.4 cases per million population per year.
The majority (70%) of endogenous CS cases are caused by excess adrenocorticotrophic hormone (ACTH) production from pituitary corticotroph tumors, known as Cushing’s disease (CD). ACTH-independent adrenal cortisol production due to an adrenal tumor or hyperplasia is responsible for 20% of CS cases. The remaining 10% of CS cases are due to ectopic ACTH (or very rarely corticotropin-releasing hormone) production.
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