Inclusion Criteria

- INCLUSION CRITERIA:

Subjects will be included if they have ALL of the three following criteria:

1. Hypercortisolism from Cushing's syndrome caused by ACTH ectopic secretion

AND

2. Glycemic disorder that is considered to be caused or worsened by the hypercortisolism

AND

3. At least one symptom attributable to the Cushing's syndrome.

EXCLUSION CRITERIA:

- Evidence for Cushing's disease as judged by positive inferior petrosal sinus
sampling or a lesion on pituitary MRI with positive CRH test

- Suspected or known adrenocortical cancer or adenomas, as judged by ACTH values
less than 10 pg/ml and adrenal mass

- Subjects with cyclic Cushing's syndrome defined by any measurement of Urinary
Free Cortisol over the previous 2 months less than 2 N

- Children (age less than 18) and patients over 85 years

- Pregnant or lactating women. A urinary pregnancy test will be performed in women
of childbearing potential unless they have a history of menopause prior to
Cushing's syndrome or hysterectomy

- Life expectancy less than two months

- Surgery planned within 8 weeks after inclusion, especially bilateral
adrenalectomy

- Uncontrolled diabetes (plasma glucose greater than 15.0 mmol/L (270 mg/L) and/or
HbA1c greater than 10%)

- Uncontrolled hypertension (blood pressure greater than 180/110 mmHg)

- Recent (less than two weeks prior to inclusion) initiation of corrective
treatments for depression

- Clinically significantly impaired cardiovascular function (e.g. stage IV cardiac
failure)

- Severe liver disease (liver enzymes greater than or equal to 3 x the
institutional upper limit of normal range)

- Severe renal impairment (serum creatinine greater than or equal to 2.2 mg/dl or
creatinine clearance less than 30 ml/min)

- Severe hypokalemia (plasma K below 3.0 mmol/L)

- Uncontrolled severe active infection

- In women, known endometrial cancer, history of endometrial hyperplasia or
vaginal bleeding of unknown cause

- Premenopausal women with hemorrhagic disorders or on anticoagulants

- Recent (less than two weeks prior to inclusion) initiation of or significant
change in dose of anti-tumor therapy

- Previous treatment with approved or experimental steroidogenesis inhibitors,
somatostatin analogues within one week of admission (eight weeks for patients on
octreotide LAR or on lanreotide autogel)

- Plasma mitotane concentration greater than 5 microgram/ml

- Impaired mental capacity or markedly abnormal psychiatric evaluation that
precludes informed consent

- Body weight over 136 kg, which is the limit for the tables used in the scanning
areas

- Inherited porphyria

- Positive pregnancy test at inclusion

- Use of antiretroviral agents, midazolam, cabergoline, erythromycin, or
grapefruit juice within two weeks of the study