What are the common causes of a buffalo hump (dorsocervical fat pad) in an adolescent female?

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Differential Diagnosis for a Buffalo Hump in an Adolescent Female

  • Single Most Likely Diagnosis
    • Cushing's syndrome: This condition, characterized by excess cortisol production, is a common cause of a buffalo hump (a fatty deposit on the back of the neck) in adolescents. The symptoms of Cushing's syndrome, including weight gain, moon face, and hirsutism, often accompany the buffalo hump.
  • Other Likely Diagnoses
    • Obesity: Simple obesity can cause a buffalo hump due to excess fat accumulation in the neck area. This is a common condition in adolescents and can be associated with other health issues.
    • Steroid use: Long-term use of corticosteroids can lead to Cushingoid features, including a buffalo hump, due to the exogenous source of cortisol.
    • Familial partial lipodystrophy: This rare genetic disorder affects fat distribution and can cause a buffalo hump, among other symptoms.
  • Do Not Miss Diagnoses
    • Pheochromocytoma: Although rare, this tumor of the adrenal gland can cause excess catecholamine production, leading to weight gain, hypertension, and potentially a buffalo hump. Missing this diagnosis could be life-threatening due to the risk of hypertensive crises.
    • Medullary thyroid carcinoma: This type of thyroid cancer can produce excess calcitonin, leading to a range of symptoms, including a buffalo hump. Early detection is crucial for effective treatment.
  • Rare Diagnoses
    • Multiple endocrine neoplasia (MEN) syndromes: These genetic disorders can cause a variety of endocrine tumors, including those that produce excess hormones leading to a buffalo hump.
    • Congenital adrenal hyperplasia: This group of genetic disorders affects the adrenal glands and can cause an overproduction of androgens, potentially leading to a buffalo hump.
    • Hypothyroidism: Severe, untreated hypothyroidism can cause changes in fat distribution, including a buffalo hump, although this is less common in adolescents.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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