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​Cushing's Disease

What is Cushing's Disease?

Cushing's disease is defined as a condition caused by chronic exposure to elevated levels of the hormone cortisol (hypercortisolism).

When a pituitary tumor is the cause of high cortisol, the disorder is called Cushing's disease.

At UPMC, the preferred Cushing’s disease treatment is to remove the pituitary tumor using the Endoscopic Endonasal Approach (EEA). This innovative, minimally invasive technique uses the nose and nasal cavities as natural corridors to access hard-to-reach or previously inoperable tumors. Benefits of EEA include:

  • No incisions to heal
  • No disfigurement
  • Faster recovery time

As an additional treatment, your surgeon may recommend Gamma Knife® radiosurgery.

Diagnosing Cushing's Disease

To make the diagnosis of Cushing's disease, your doctor will ask you about your symptoms and order diagnostic lab tests for cortisol.

Symptoms of Cushing's disease

Cushing's disease symptoms may include:

  • Weight gain of the upper body and trunk
  • Moon-shaped face
  • Skin changes, such as darkening, purple stretch marks, acne, or easy bruising
  • In women: excess hair growth and menstrual disorders
  • Decreased fertility and libido
  • High blood pressure
  • Water retention or swelling
  • High blood sugar or diabetes
  • Tiredness or fatigue
  • Personality changes or mood swings
  • Muscle weakness
  • Osteoporosis

Tests for diagnosing Cushing's disease

Diagnosing Cushing's disease requires laboratory studies demonstrating high levels of blood cortisol.

If tests show that cortisol levels are above normal, your doctor must identify the reason to determine the best treatment plan.

Cushing's Disease Treatments

Minimally invasive surgery

For most cases of Cushing’s disease, the best treatment is to remove the pituitary tumor that is causing the excessive levels of cortisol.

The pituitary tumor can be approached directly using the Endoscopic Endonasal Approach (EEA).

This state-of-the-art, minimally invasive approach allows surgeons to access the tumor through the natural corridor of the nose, without making an open incision. Surgeons then remove the pituitary tumor through the nose and nasal cavities.

EEA offers the benefits of no incisions to heal, no disfigurement, and a faster recovery time.

If you need complementary Cushing's disease treatments, such as radiation, those therapies can begin soon after EEA surgery.

Gamma Knife® radiosurgery for Cushing's disease

Gamma Knife radiosurgery uses hundreds of highly focused radiation beams to target the pituitary tumor that's causing Cushing's disease, with no surgical incision.

For Cushing's disease, Gamma Knife treatment is used for residual pituitary tumor after surgery or elevated cortisol hormone levels despite surgery and medical management.

UPMC is the nation's leading provider of Gamma Knife procedures. Our treatments have proven effective for more than 12,000 people with tumors, vascular malformations, pain, and other functional problems.


Gamma Knife Radiosurgery
Dr. L. Dade Lunsford discusses Gamma Knife Radiosurgery.


Endoscopic Endonasal Approach (EEA)
Pituitary Tumor Removal Using the Endoscopic Endonasal Approach (EEA) at UPMC

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