Depending on the size of the tumor, clinical signs other than those of Cushing's disease may be present, since a large tumor might press on or interfere with nearby structures in the area. Pituitary gland tumors may be microscopic or large. If the pituitary senses increased levels of cortisol, it will produce less ACTH, thereby reducing production of cortisol. As shown in the illustration below, as the pituitary gland produces more ACTH, it triggers the adrenal glands to produce more cortisol. The tumor causes the pituitary gland to overproduce a hormone (ACTH) that stimulates the adrenal glands to produce cortisol. The tumor may be either benign (harmless) or malignant (cancerous). The most common cause of Cushing's disease (85% - 90% of all cases) is a tumor of the pituitary gland (which is located at the base of the brain). "Identifying the cause of Cushing’s disease is important because each type is treated differently and each has a different prognosis."
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