Which of the following is false about Nelson’s syndrome
**Core Concept**
Nelson's syndrome is a rare condition that occurs in some patients who have undergone bilateral adrenalectomy for Cushing's disease. It is characterized by the development of a pituitary tumor, typically a corticotrophin-secreting adenoma, which leads to excessive ACTH production and resulting hyperpigmentation.
**Why the Correct Answer is Right**
Nelson's syndrome is a consequence of removing the adrenal glands in patients with Cushing's disease. Normally, the adrenal glands produce cortisol, and the pituitary gland regulates this production through the release of ACTH. When the adrenal glands are removed, the pituitary gland continues to produce ACTH, but without target organs, the feedback inhibition is lost, leading to an increase in ACTH production and the development of a pituitary tumor. The tumor secretes excessive amounts of ACTH, causing hyperpigmentation, and can also lead to an increase in melanin production.
**Why Each Wrong Option is Incorrect**
* **Option A:** Incorrect because Nelson's syndrome is indeed associated with the development of a pituitary tumor.
* **Option B:** Incorrect because Nelson's syndrome is characterized by excessive ACTH production, which leads to hyperpigmentation.
* **Option C:** Incorrect because Nelson's syndrome is a known complication of bilateral adrenalectomy in patients with Cushing's disease.
**Clinical Pearl / High-Yield Fact**
Nelson's syndrome is a rare but serious complication of bilateral adrenalectomy, and its diagnosis requires a high index of suspicion. It is essential to monitor patients with a history of Cushing's disease closely for signs of pituitary tumor development.
**Correct Answer: D**