The evolution of ideas concerning the aetiology of Cushing’s syndrome over the past 70 years is reviewed briefly. It is now agreed that about 70% of patients have a pituitary adenoma, not necessarily basophil, the removal of which results in remission but follow-up is currently too short for assessment of ultimate cure. Whether or not the pituitary lesion is primary or secondary to events in the cerebrum or brainstem is discussed, but a definite answer cannot be given at present.
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