title: A Case of Acute Aortic Dissection Type B Associated with Cushing's Syndrome.
abstract: We report a case of a 63-year-old man, with a previous history of hypertension and glucose intolerance associated troncular obesity that was emergently admitted to our Institution for evaluation of a severe, constant posterior chest pain which radiated anteriorly and dyspnoea with a suspected diagnosis of acute aortic dissection. A CT scan of thorax and abdomen demonstrated a dissection starting just below left succlavian artery and extending downward to the left renal artery, involving the celiac tripod and superior mesenteric artery. The dissection was classified as Stanford B, De Bakey III. Moreover, CT scan of abdomen revealed incidentally a left adrenal tumor of 25 mm of diameter. An emergent prosthetic graft was placed just below the origin of the left succlavian artery up-to the diaphragmatic hiatus. Furthermore, a diagnostic evaluation of the mass revealed an increase of cortisol production, and a diagnosis of Cushing's syndrome was done and the patient underwent an adrenalectomy via laparotomic approach. We report an association of acute aortic dissection of acute aortic dissection type B associated to Cushing's syndrome.
  
  
  BACKGROUND
  Cushing's syndrome; Adrenocortical adenoma; Aortic dissection type B.
authors.affiliation: Day Hospital of Internal Medicine and Hypertension-Department of Clinical Science University "Sapienza", Rome, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Petramala
authors.forename: Dario
authors.initials: D
authors.lastname: Cotesta
authors.forename: Paolo
authors.initials: P
authors.lastname: Sapienza
authors.forename: Laura
authors.initials: L
authors.lastname: Zinnamosca
authors.forename: Enrico
authors.initials: E
authors.lastname: Moroni
authors.forename: Luca
authors.initials: L
authors.lastname: di Marzio
authors.forename: Giorgio
authors.initials: G
authors.lastname: De Toma
authors.forename: Claudio
authors.initials: C
authors.lastname: Letizia