[Addisonian crisis caused by metastatic lung cancer. Report of one case].
Addisonian crisis as a first manifestation of metastatic disease secondary to cancer is uncommon. We report a 63-year-old man with a history of one year of fatigue, weakness, weight loss and repeated symptomatic hypoglycemia. The cortisol stimulation test with ACTH confirmed primary adrenal insufficiency. While receiving adequate treatment with oral hydrocortisone, he presented an adrenal crisis that was treated properly. A CT scan of the lung demonstrated a nodule in the upper right lobe and bilateral adrenal tumors. The biopsy of the lesion revealed a lung adenocarcinoma. The staging with positron emission tomography using 18 fluoroglucose (PET/CT18F- FDG) showed hypermetabolic uptake in the primary lung tumor and in both adrenal glands, suggesting metastatic implants.
Departamento de Medicina Oriente, Escuela de Medicina, Universidad de Chile, Santiago, Chile. Utreras.carlos@gmail.com
Carlos
C
Utreras
René E
RE
Díaz
Rodrigo
R
Ascui
Rodrigo
R
Caro
Jesús
J
Véliz
Nelson
N
Wohllk
D000224:Addison Disease / Q000000981:diagnostic imaging / Q000209:etiology*; D000230:Adenocarcinoma / Q000175:diagnosis / Q000556:secondary*; D000310:Adrenal Gland Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary*; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18