Contributed by Sanja Dacic, MD and Prabha B. Rajan, MD
Published on line in April 1998
The patient is a 41-year-old Caucasian female who was admitted to the hospital for evaluation of high blood cortisol level. Her complaints were fatigue, weakness, lethargy, decreased concentration and decreased memory over the last 18 months. She also gained 40 lbs over the last two months with central distribution of weight gain and neck obesity. Her physical examination was remarkable for cushingoid appearance with body weight of 211 lbs, palmar erythema and hirsutism. Dexamethasone suppression test results were consistent with Cushing's disease. A magnetic resonance imaging (MRI) examination of the pituitary did not show any abnormal findings. However, CT scan of the chest with contrast revealed a left upper lobe lung nodule, measuring 1.5x1.5 cm.