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As a third-year medical student, you examine your first patient. You find that he is 52 years old, has a round face, acne, and a large hump of fat on the back of his neck. He complains that he is too weak to mow his lawn. His fasting blood glucose level is 170 mg/dL (reference range, 80 to 100 mg/dL). His plasma cortisol levels are 62 μ g/mL (reference range, 3 to 31 μ g/mL). His plasma ACTH levels are 0 pg/mL (reference range, 0 to 100 pg/mL). Based on the information given, if the patient ’ s problem is attributable to a single cause, the most likely diagnosis is which one of the following?
A.
Non – insulin-dependent diabetes mellitus
B.
Insulin-dependent diabetes mellitus
C.
A secretory tumor of the anterior pituitary
D.
A secretory tumor of the posterior pituitary
E.
A secretory tumor of the adrenal cortex