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A 53-year-old woman was admitted because of hypertension and diabetes inellitus. Elevated diastolic blood pressure, hypertensive retinopathy and renal dysfunction indicated malignant hypertension. Adrenocorticotropic hormone (ACTH)and cortisol levels were high although there were no Cushingoid features.One mgdexamethasone administration decreased neither ACTHnor cortisol levels. Brain magnetic resonance imaging revealed a left pituitary tumor (7 mmx 6 mm).Uponremoval, the tumor showed positivedoi:10.2169/internalmedicine.41.566 fatcat:jsfw7vgiyjcafa5lrx7bpmjxma