ABSTRACT
A third episode of Cushing's syndrome developed in an adult male who had undergone subtotal adrenalectomy and then complete hypophysectomy in temporarily successful treatment of two earlier episodes. Judging from necropsy findings, this final recurrence was not the result of incomplete pituitary ablation or regeneration of pituitary remnants. Extrasellar pituitary or other ACTH secreting tissue could not be identified, but the patient's marked melanosis suggested its presence with consequent excesses of ACTH or MSH. However, irrespective of whether such excesses did or did not exist, it is clear that the third episode of Cushing's syndrome resulted from hyperfunction of the small adrenal remnant.
