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Research Letter |

The Musical Footprint of Cushing Syndrome

Louis-Marie Terrier, MD1; Aymeric Amelot, MD, PhD2; Stéphane Velut, MD, PhD1; Patrick François, MD, PhD1; Ilyess Zemmoura, MD, PhD1
[+] Author Affiliations
1Department of Neurosurgery, Bretonneau University Hospital, Tours, France
2Department of Neurosurgery, La Pitié-Salpétrière University Hospital, Paris, France
JAMA Intern Med. 2016;176(7):1016-1017. doi:10.1001/jamainternmed.2016.2078.
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This case report describes a patient presenting with the lyre-shaped abdominal striae associated with Cushing syndrome.

Endogenous pathologic hypercortisolism, or Cushing syndrome, is associated with poor quality of life, morbidity, and increased mortality.1 The clinical presentation of Cushing syndrome varies, in part related to the extent and duration of cortisol excess.2 When hypercortisolism is severe, its signs and symptoms are unmistakable. In particular, proximal muscle weakness; increased fat in the abdomen, torso, and face; and wide purple striae suggest marked hypercortisolism.

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Figure 1.
Abdominal Striae

A, Patient photograph of abdominal striae taking the shape of a lyre, an instrument associated in the Greek mythology with Apollo, God of art, music, and poetry. B, L’Assemblée des Dieux, by Louis Matout,1868. Photograph copyright Musée du Louvre, Dist. RMN–Grand Palais/Etienne Revault, Paris, France.

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Figure 2.
Brain Magnetic Resonance Images (MRIs)

A, Preoperative MRI of pituitary microadenoma (white arrowhead). B, Postoperative MRI showing complete removal.

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