To explore the etiology, clinical manifestations, diagnosis and treatment of rare cases of pregnancy complicated with Cushing syndrome.

The clinical data of 2 cases of pregnancy complicated with Cushing syndrome in our hospital were retrospectively analyzed, and the relevant literatures were reviewed and discussed. Case 1, a 29-year-old patient, was admitted to the Department of Endocrinology due to "25 weeks of gestation, skin silt and ecchyma on the limbs for 2 months, and left leg trauma for half a day". Abdominal ultrasound revealed a 35 mm×29 mm hypoechoic mass in the left adrenal region. After examination, she was diagnosed as pregnant with cushing syndrome and had severe mental disorder. The patient and her family members asked to terminate the pregnancy. After correction of hypokalemia, the patient was transferred to Urology Department for laparoscopic resection of the left adrenal gland tumor, with some normal glands preserved during the operation. Case 2, a 28-year-old patient, was admitted to the Department of Endocrinology of our hospital due to "22 weeks of gestation and blood glucose elevation for 1 month". Abdominal MRI examination revealed a 45 mm×59 mm mass in the left adrenal gland. Upon examination, the patient was diagnosed as pregnant with Cushing syndrome, and abnormal liver function. The abnormal liver function was considered to be related to her abnormal increase of cortisol. The patient and her family members required the termination of pregnancy after adrenal surgery, so the patient was transferred to the urology department for laparoscopic resection of the left adrenal gland tumor.

Both operations were completed successfully. Postoperative pathological findings of both cases were adrenal cortical adenoma. Case 1 was treated with low dose Glucocorticoid supplementation because the postoperative monitoring cortisol level was lower than normal. The pregnancy was terminated 2 weeks after operation in both patients. Case 1 was followed up for 12 months. In this case, cortisol returned to normal 3 months after low-dose Glucocorticoid supplementation, and hormone supplementation was stopped. Her cortisol was normal in subsequent follow-up visits. The patient's mental disorder symptoms after symptomatic drug treatment gradually improved and gradually returned to normal. Case 2 had been followed up for 6 months, and the cortisol and aminotransferase of the patient returned to normal after the operation. Follow-up examinations of electrolyte and other related hormones were normal in both patients.

Pregnancy with Cushing syndrome is rare in clinic, which is harmful to pregnant women and fetus, and should be diagnosed timely. The condition of the pregnant woman and the fetus should be evaluated comprehensively, and the appropriate individualized treatment plan should be selected.