PMID: 18195500Jan 16, 2008Paper

Impaired consciousness caused by a metastatic adrenal tumor of pulmonary adenocarcinoma

Internal Medicine
Kyouko YokosukaYasuo Matsuzawa

Abstract

We report a case of pulmonary adenocarcinoma metastasizing to the adrenal glands, which caused adrenal insufficiency leading to impaired consciousness. A 62 year-old man was admitted with impaired consciousness. The patient started chemotherapy from 2004 for pulmonary adenocarcinoma. In August 2004, a metastatic adrenal tumor was detected and chemotherapy was continued thereafter. From July 2005, the patient started to have mild hyperkalemia, anorexia and general malaise, which progressed to disturbance of consciousness. At admission, physical examination showed generalized pigmentation in the skin and mucosa. Blood test revealed hypoglycemia, hyponatremia and hyperkalemia. A dexamethasone suppression test and a rapid ACTH loading test led to a diagnosis of primary hypoadrenalism (Addison's disease). Treatment with hydrocortisone improved the physical status and blood test values. However, the patient subsequently died of disseminated intravascular coagulation due to the tumor.

References

Jun 28, 2000·European Journal of Endocrinology·A LutzM Reincke

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Citations

Jan 1, 2009·BMJ Case Reports·Neil Sahasrabudhe, Richard Byers
Apr 25, 2009·Current Opinion in Endocrinology, Diabetes, and Obesity

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