Abstract
Abstract:The adrenals are a common site of metastases for lung cancers; adrenal insufficiency, however, as a presenting feature of lung cancer, is extremely rare. We report a case of primary adrenal insufficiency secondary to metastases from adenocarcinoma of the lung. Our patient presented with hypotension, abdominal pain, and weight loss. CT scans showed a right upper lobe mass and bilateral adrenal masses. The frequent occurrence of constitutional symptoms, metabolic derangements, and cardiovascular compromise in patients with advanced cancer may lead to an underestimation of the true incidence of adrenal insufficiency in this population.
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References
References1. Oelkers W. Adrenal insufficiency. N Engl J Med 1996;335:1206–1212.OelkersWAdrenal insufficiency.N Engl J Med19963351206-12122. Charalambous S, Mylonaki E, Fotas A, et al. Large adrenal metastasis in non-small cell lung carcinoma. Case report and literature review. Tumori 2008;94:134–136.CharalambousS]]MylonakiE]]FotasA&etal;Large adrenal metastasis in non-small cell lung carcinoma. Case report and literature review.Tumori200894134-1363. Sahagian-Edwards A, Holland JF. Metastatic carcinoma to the adrenal glands with cortical hypofunction. Cancer 1954;7:1242–1245.Sahagian-EdwardsA]]HollandJFMetastatic carcinoma to the adrenal glands with cortical hypofunction.Cancer195471242-12454. Seidenwurm DJ, Elmer EB, Kaplan LM, et al. Metastases to the adrenal glands and the development of Addison’s disease. Cancer 1984;54:552–557.SeidenwurmDJ]]ElmerEB]]KaplanLM&etal;Metastases to the adrenal glands and the development of Addison’s disease.Cancer198454552-5575. Cedermark BJ, Sjöberg HE. The clinical significance of metastases to the adrenal glands. Surg Gynecol Obstet 1981;152:607–610.CedermarkBJ]]SjöbergHEThe clinical significance of metastases to the adrenal glands.Surg Gynecol Obstet1981152607-6106. Redman BG, Pazdur R, Zingas AP, et al. Prospective evaluation of adrenal insufficiency in patients with adrenal metastasis. Cancer 1987;60:103–107.RedmanBG]]PazdurR]]ZingasAP&etal;Prospective evaluation of adrenal insufficiency in patients with adrenal metastasis.Cancer198760103-1077. Sheeler LR, Myers JH, Eversman JJ, et al. Adrenal insufficiency secondary to carcinoma metastatic to the adrenal gland. Cancer 1983;52:1312–1316.SheelerLR]]MyersJH]]EversmanJJ&etal;Adrenal insufficiency secondary to carcinoma metastatic to the adrenal gland.Cancer1983521312-13168. Rosenthal FD, Davies MK, Burden AC. Malignant disease presenting as Addison’s disease. Br Med J 1978;1:1591–1592.RosenthalFD]]DaviesMK]]BurdenACMalignant disease presenting as Addison’s disease.Br Med J197811591-15929. Payne DK, Levine SN, Franco DP, et al. Adrenal insufficiency due to metastatic lung carcinoma and shown by abdominal CT scan. South Med J 1984;77:1592–1593.PayneDK]]LevineSN]]FrancoDP&etal;Adrenal insufficiency due to metastatic lung carcinoma and shown by abdominal CT scan.South Med J1984771592-159310. Amador E. Adrenal hemorrhage during anticoagulant therapy. Ann Intern Med 1965;63:559–571.AmadorEAdrenal hemorrhage during anticoagulant therapy.Ann Intern Med196563559-57111. Tricando P, Playán J, Acha J, et al. Adrenal failure due to metastasis both to the hypothalamic-pituitary area and the adrenals. Tumori 1996;82:401–404.TricandoP]]PlayánJ]]AchaJ&etal;Adrenal failure due to metastasis both to the hypothalamic-pituitary area and the adrenals.Tumori199682401-40412. Modhi G, Bauman W, Nicolis G. Adrenal failure associated with hypothalamic and adrenal metastases. Cancer 1981;47:2098–2101.ModhiG]]BaumanW]]NicolisGAdrenal failure associated with hypothalamic and adrenal metastases.Cancer1981472098-210113. Barker NW. The pathologic anatomy in twenty-eight cases of Addison’s disease. Arch Pathol 1929;8:432–450.BarkerNWThe pathologic anatomy in twenty-eight cases of Addison’s disease.Arch Pathol19298432-45014. Magnotti M, Shimshi M. Diagnosing adrenal insufficiency: which test is best–the 1-microg or the 250-microg cosyntropin stimulation test? Endocr Pract 2008;14:233–238.MagnottiM]]ShimshiMDiagnosing adrenal insufficiency: which test is best–the 1-microg or the 250-microg cosyntropin stimulation test?Endocr Pract200814233-238