Learning Objectives:

1.  Recognize the diverse phenotypic expression of neoplastic hypercortisolism (formerly known as Cushing syndrome) and how to differentiate it from non-neoplastic hypercortisolism (formerly known as pseudo-Cushing syndrome).

2. Review strategies of when to screen patients for neoplastic hypercortisolism.

3. Examine the limitations of current biochemical testing for neoplastic hypercortisolism with special emphasis on mild cortisol excess associated with adrenal nodular disease.