Cushing syndrome is a rare but severe endocrine disorder characterized by chronic exposure to excess glucocorticoids, leading to significant morbidity and increased mortality. Despite advances in endocrinology, its heterogeneous etiology and overlapping clinical features continue to pose diagnostic and therapeutic challenges. Cushing syndrome is broadly classified into adrenocorticotropic hormone (ACTH)-dependent and ACTH-independent forms, each with distinct pathophysiological mechanisms. Advances in biochemical testing, imaging techniques, and invasive diagnostic procedures such as inferior petrosal sinus sampling have improved diagnostic accuracy. Surgical intervention remains the cornerstone of treatment, while medical therapies and radiotherapy serve as adjuncts or alternatives in selected cases. Persistent cardiovascular, metabolic, and neuropsychiatric complications may occur even after biochemical remission.
This review aims to provide a comprehensive overview of the current understanding of Cushing syndrome, focusing on its pathophysiology, etiological classification, diagnostic strategies, and contemporary management approaches based on recent literature.

Cushing syndrome; hypercortisolism; ACTH-dependent; ACTH-independent; endocrine disorders; diagnostic approach; management

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