Occult Cushing\u27s Syndrome Presenting with Osteoporosis

Osteoporosis is a frequent complication both of endogenous hypercortisolism and of long-term treatment with corticosteroids, but only rarely is it the major clinical feature with the more characteristic features absent or minimally present. In the two patients presented, hypercortisolism was uncovered only during routine evaluation of osteoporosis. This presentation is probably due to slow progression of the disease and is often associated with so-called black adenoma of the adrenal gland. Secondary causes should be sought in all patients with seemingly senile or postmenopausal osteoporosis