Marek Felšöci, Hedviga Wagnerová, Ivica Lazúrová
Intermittent (cyclic) Cushing’s syndrome (CS) is a rare disease, characterized by repeated episodes of hypercortisolism interrupted by periods of normal cortisol secretion. Generally accepted criteria to diagnose cyclic CS include three peaks and two troughs of cortisol production. The cycle frequency may intra- and interindividually vary from 10 times in 3 months to twice in 5 years. Up to now only 65 cases were reported worldwide. In 54 % of all cases disease is determined by a pituitary ACTHsecreting adenoma, in 26 % by an ectopic ACTH-producing tumour and in about 11 % by an adrenal tumour, the remainder are unclassified. The pathophysiology of disease is largely unknown. The clinical signs of cyclic CS are similar to noncyclic and can be either partial or fully manifestated. Thanks to fluctuating clinical picture and time-depending biochemical findings intermittent CS is extremely hard to diagnose. We report a case of a 66-year-old woman with a severe hypercortisolism and spontaneous regression within three months.