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Vol.40 No.6 contents | Japanese/English |
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- Case Report -
A Case of Addison's Disease Due to Bilateral Adrenal Metastasis of Adenocarcinoma of the Lung
Yoriko Nishizawa1, Kazuo Kasahara2, Saori Myou1, Yoshinori Kibe1, Masahide Yasui2, Masaki Fujimura2 and Shinji Nakao21Depertment of Respiratory disease, Kanazawa National Hospital, 2Third Department of Internal Medicine, Kanazawa University School of Medicine
Case: A 52-year-old man, who had undergone lobectomy and left adrenalectomy two years prenously because of lung adenocarcinoma with left isolated adrenal metastasis, was admitted with general malaise and nausea after upper respiratory tract infection. He had skin and mucosal pigmentation, and the laboratory data showed hyponatremia and hyperkalemia. Abdominal CT showed a grossly enlarged residual right adrenal gland. Serum ACTH level was high, cortisol and aldosterone levels were low, and their circadian rhythms were absent. He had no response to rapid ACTH stimulation, and thus we diagnosed Addison's disease due to bilateral adrenal metastases of the lung adenocarcinoma. Hydrocortisone replacement therapy resulted in rapid improvement of his general condition and laboratory data. Conclusion: Although metastases to the adrenal glands are common in patients with lung cancer, Addison's disease has been rarely noted. Since adrenal insufficiency may develop abruptly, it is important to examine physical findings and past history. Furthermore, adrenal function tests and diagnostic imaging should be done in these cases.
key words: Addison's disease, Adrenal metastasis, Lung cancer, Adrenalectomy
Received: March 31, 2000
Accepted: June 5, 2000
JJLC 40 (6): 623-627, 2000
