The elusive Minnie G.: revisiting Cushing's case XLV, and his early attempts at improving quality of life.

Although researchers have discovered that Minnie G. had nearly 50 years of progression-free survival, the absence of her original surgical records have precluded anything more than speculation as to the etiology of her symptoms or the details of her admission. Following IRB approval, and through the courtesy of the Alan Mason Chesney Archives, the microfilm surgical records from the Johns Hopkins Hospital, 1896-1912 were reviewed. Using the surgical number provided in Cushing's publications, the record for Minnie G. was recovered for further review. Cushing's diagnosis relied largely on history and physical findings. Minnie G. presented with stigmata associated with classic Cushings Syndrome: abdominal stria, supraclavicular fat pads, and a rounded face. However, she also presented with unusual physical findings: exophthalmos, and irregular pigmentation of the extremities, face, and eyelids. A note in the chart indicates Minnie G. spoke very little English, implying the history-taking was fraught with opportunities for error. Although there remains no definitive etiology for Minnie G.'s symptoms, this report contributes additional information about her diagnosis and treatment.