TURKISH JOURNAL OF ONCOLOGY 2008 , Vol 23 , Num 2
Adrenal insufficiency caused by bilateral adrenal macrometastases: a rare case with metastatic colon cancer
İrfan ÇİÇİN,1 Sernaz UZUNOĞLU,1 Hakan KARAGÖL,1 Ufuk USTA,2 Osman TEMİZÖZ,3 Nilay ERMANTAŞ1
1 Trakya Üniversitesi Tıp Fakültesi, Medikal Onkoloji Anabilim Dalı, Edirne
2 Trakya Üniversitesi Tıp Fakültesi, Patoloji Anabilim Dalı, Edirne
3 Trakya Üniversitesi Tıp Fakültesi, Radyoloji Anabilim Dalı, Edirne
A 42-year-old male with symptoms of weight loss, fatigue, hyponatremia, hypoglycemia, hypotension and fever was referred to our hospital. A computed tomographic scan of the abdomen and pelvis showed multiple solid masses in the liver, thickened wall of sigmoid colon and bilateral solid adrenal masses, 7x5x3 cm on the right side and 6x4.5x3.5 cm on the left side. A colonoscopic examination showed tumoral mass originating from the sigmoid colon. A biopsy was performed and adenocarcinoma was diagnosed. The patient was suspected of having primary adrenal insufficiency due to bilateral adrenal macrometastases. The diagnosis of adrenal insufficiency was confirmed by levels of ACTH serum, cortisol and ACTH stimulation test. Adrenal metastases are well-recognized, but compared with the prevalence of adrenal metastases, adrenocortical insufficiency in patients with cancer seems to be rare. We report the case of a patient with both bilateral surrenal macrometastases, which is rare in colorectal cancer, and subsequent adrenal insufficiency. Keywords : Adrenal insufficiency; colon cancer; macrometastases