本文报道1例12周岁女性患儿，因“其体重增长过快，超于同龄儿3月”入院，临床试验提示患儿存在糖耐量受损并胰岛素抵抗，皮质醇昼夜节律消失，高皮质醇血症，肝脏超声提示，中度脂肪肝，颅脑及垂体MRI检查提示，腺垂体右侧小结节影，后行双侧岩下窦静脉采血，得以确诊为儿童库欣病，经神经内镜下经鼻腔-蝶窦垂体病损切除术，切除垂体微腺瘤，患儿出院后半年减重27 kg，本病例及文献复习对青少年疑难库欣病的诊断和治疗具有参考价值。

This paper reports the case of a 12-year-old female patient admitted for excessive weight gain surpassing her peers over a three-month period. Laboratory investigations revealed impaired glucose tolerance with insulin resistance, hypercortisolemia, and a disrupted cortisol circadian rhythm. Abdominal ultrasound showed moderate hepatic steatosis (fatty liver), and pituitary MRI suggested a small nodule in the right adenohypophysis. The patient was subsequently diagnosed with pediatric Cushing's disease following bilateral inferior petrosal sinus sampling (BIPSS). She underwent endoscopic endonasal transsphenoidal resection of the pituitary microadenoma; at the six-month follow-up, she had achieved a weight loss of 27 kg. This case report and literature review offer a valuable clinical reference for the diagnosis and management of challenging cases of adolescent Cushing's disease.