Objective: To present two clinical cases of pediatric Cushing disease caused by
adrenocorticotropic hormone secreting pituitary adenomas, which were
diagnosed by magnetic resonance imaging using 3 Tesla technology.Case description: Two cases of Cushing disease in 9-year-old children are reported. Both
children presented pituitary adenomas that were smaller than 5 mm at their
largest diameter, and which were not seen by standard 1.5 Tesla resonance.
One of the patients was submitted to bilateral and simultaneous
catheterization of the inferior petrosal sinus, but the result was
undetermined. In both cases, the pituitary adenoma was detected by 3 Tesla
magnetic resonance imaging. Both patients underwent transsphenoidal surgery
and were cured.Comments: Cushing disease presents high morbidity. Therefore, early diagnosis and
prompt treatment are essential. It is usually caused by adenomas that are
smaller than 5 mm in diameter. Surgery is the first line of treatment, and
effective methods of locating the adenoma are necessary for greater
therapeutic success. This report suggests that the 3 Tesla magnetic
resonance imaging is more sensitive, and thus able to detect pituitary
microadenomas (largest diameter <10 mm). This exam may be indicated as a
low-morbidity diagnostic tool for finding pituitary microadenomas in Cushing
disease that are not visualized by 1.5 Tesla magnetic resonance imaging.