We have considered the combination of Nelson’s syndrome, empty sell syndrome and diffuse toxic goiter. Hypersecretion of proopiomelanocortin and melanocyte-stimuliating hormone was caused by pituitary hyperactivity in a small amount of residual gland or by ectopic secretion. Hyperthyroidism was apparently co-morbidity. The clinical case illustrates a combination of symptoms of hypocortisolism and hyperthyroidism, both of the maggravate the patient’s condition. Substitution therapy for adrenal insufficiency and thyroid function suppressing has allowed to achieve the clinical and laboratory remission and the regression of skin pigmentation in a rather short time.
