# Clinical Images in Emergency Medicine: Cushing’s Disease

## TL;DR

A young woman with Cushing’s disease was diagnosed after showing symptoms like weight gain and facial swelling, leading to discovery of a pituitary tumor.

## Contribution

Highlights the importance of recognizing rare Cushing’s disease in emergency settings to avoid diagnostic delays.

## Key findings

- A 22-year-old female was diagnosed with Cushing’s disease via MRI revealing a pituitary macroadenoma.
- Symptoms like fatigue and weight gain can mimic common disorders, leading to delayed diagnosis.
- Emergency physicians should maintain a high suspicion for Cushing’s disease in similar presentations.

## Abstract

A 22-year-old female presented to the emergency department with a two-month history of worsening fatigue, unintentional weight gain, and progressive facial swelling. Physical examination findings included hirsutism, moon facies, and abdominal striae. Subsequent brain magnetic resonance imaging revealed the presence of a 2.4-centimeter pituitary macroadenoma, confirming the diagnosis of Cushing’s disease. The patient was then admitted for neurosurgical tumor resection.

Cushing’s disease is exceedingly rare and often presents with symptoms resembling more prevalent disorders, contributing to delays in diagnosis. Therefore, maintaining a high index of suspicion for this disease is crucial for emergency physicians.