A 47-year-old woman with a seven-month history of increasing weight, hypertension and recently diagnosed diabetes presented features of hirsutism, frontal baldness, amenorrhea and hypokalemia.These characteristics were considered diagnostic of Cushing’s syndrome, and studies were initialized to identify its etiology. During hospitalization, the patient presented a torpid evolution resulting in death. Clinical autopsy revealed a 400 g carcinoma in the left adrenal gland, liver metastasis and a massivevena cava tumor thrombus which was the final cause of death. doi: http://dx.doi.org/10.7705/biomedica.v32i4.568