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In patients with a clinical suspicion of Cushing`s disease without a suggestive pituitary lesion on magnetic resonance imaging (MRI), bilateral inferior petrosal sinus sampling (BIPSS) provides excellent specificity and higher sensitivity than the other currently available biochemical testing strategies and despite its invasive nature, the complication rates are low when performed by a trained interventionist. Double superior vena cava (SVC) has no known association with Cushing`s disease, but the presence of such congenital venous anomaly makes the procedure of bilateral inferior petrosal sinus sampling (BIPSS) technically more challenging, therefore having a sound anatomical knowledge of such rare venous anomaly is paramount for the procedure to be performed safely and successfully.






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Role of bilateral inferior petrosal sinus sampling (BIPSS) in the diagnosis of Cushing`s disease in a patient with double superior vena cava

Free full text article: Role of bilateral inferior petrosal sinus sampling (BIPSS) in the diagnosis of Cushing`s disease in a patient with double superior vena cava

Abstract
Cushing`s syndrome is known to have a wide spectrum of clinical presentation with debilitating consequences and morbidity if not diagnosed and treated in time. Sometimes the diagnosis of Cushing`s syndrome can be challenging to the endocrinologist, especially when the usual battery of biochemical tests and advanced cross-sectional imaging is negative or inconclusive. We described a case in which the use of bilateral inferior petrosal sinus sampling (BIPSS) was conclusive albeit being technically challenging (due to a rare incidental finding of double superior vena cava) and invasive in nature.






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1. Bilateral inferior petrosal sinus sampling

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