Gastric carcinoma presenting with adrenal insufficiency caused by bilateral adrenal metastasis

Gul, Waheed; Qazi, Arif; Barde, Christopher J.

doi:10.1016/j.gie.2008.04.001

Cited by 6 publications

(5 citation statements)

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“…1). Four case reports did not meet inclusion criteria leaving 13 cases reports [14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26], one case series of four patients [27] and six original research articles [13, 28, 29, 30, 31, 32]. Of these original research articles, four articles met criteria for the initial prevalence calculation requiring bilateral disease and ACTH stimulation test to diagnose AI.…”

Section: Resultsmentioning

confidence: 99%

Adrenal insufficiency due to bilateral adrenal metastases – A systematic review and meta-analysis

Tallis

Rushworth

Torpy

et al. 2019

Heliyon

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Objective Bilateral adrenal metastases may cause adrenal insufficiency (AI) but it is unclear if screening for AI in patients with bilateral adrenal metastases is justified, despite the potential for adrenal crises. Method A search using PubMed/Medline, ScienceDirect and Cochrane Reviews was performed to collect all original research articles and all case reports from the past 50 years that describe AI in bilateral adrenal metastases. Results Twenty studies were included with 6 original research articles, 13 case reports and one case series. The quality was generally poor. The prevalence of AI was 3–8%. Of all cases of AI (n = 25) the mean pooled baseline cortisol was 318 ± 237 nmol/L and stimulated 423 ± 238 nmol/L. Hypotension was present in 69%, hyponatremia in 9% and hyperkalemia in 100%. Lung cancer was the cause in 35%, colorectal 20%, breast cancer 15% and lymphoma 10%. The size of the adrenal metastases was 5.5 ± 2.8 cm (left) and 5.5 ± 3.1 cm (right), respectively. There was no correlation between basal cortisol, stimulated cortisol concentration or ACTH with the size of adrenal metastases. The median time to death was 5.0 months (IQR 0.6–6.5). However, two cases were alive after 12–24 months. Conclusion The prevalence of AI in patients with bilateral adrenal metastases was low. Prognosis was very poor. Due to the low prevalence of AI, screening is likely only indicated in patients with symptoms and signs suggestive of hypocortisolism.

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Section: Resultsmentioning

confidence: 99%

Adrenal insufficiency due to bilateral adrenal metastases – A systematic review and meta-analysis

Tallis

Rushworth

Torpy

et al. 2019

Heliyon

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“…Lomte et al in their retrospective analysis of 70 patients with bilateral adrenal masses from western India could not find any of their metastatic cases to be associated with primary adrenal insuffi -ciency.Hypocortisolism was more common in tuberculosis in their series.They advise while evaluating for bilateral adrenal masses age at presentation,presenting symptoms,lesion size,and biochemical features to be helpful in delineating varied underlying aetiologies 6 . Other sites from where metastasis to adrenals can occur are colon,stomach,ovaries,and advanced papillary thyroid cancer 5,7,8 .…”

Section: Discussion:-mentioning

confidence: 99%

Bilateral Adrenal Metastasis Presenting as Adrenal Insufficiency.

Sinha¹,

ijar²

2018

IJAR

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The adrenal glands are the fourth most common site of distant metastasis after lung,liver and bone. The incidence of adrenal metastasis is high in bronchogenic and breast carcinoma.On the other hand clinical adrenal de ficiency due to metastasis is very rare 1 .In patients with cancer, adrenal insu fficiency may go unrecognized because the symptoms such as weakness, anorexia,nausea,vomiting ,orthostatic hypotension, electrolyte abnormalities are nonspecific and may be attributed to the underlying progressive malignancy. Moreover, terminal stage cancer patients can have symptoms that overlap with symptoms of adrenal insuffciency.We here report a case of 80 year old male, nonsmoker who presented with loss of more than 25 kg body weight in a span of two months. His plain x-ray chest was normal but computed tomography of abdomen revealed incidental bilateral large adrenal masses.His haematological and biochemical tests revealed no significant abnormality except low plasma protein and low albumen.Hormonal examination for assessment of corti-sol status confirmed primary adrenal insufficiency.PET-CT revealed the primary site to be in lungs.

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“…In this patient, bilateral adrenal metastases were present at the time of the initial diagnosis, being responsible for clinical evident adrenal insufficiency. There are only a few reports of adrenal insufficiency or true Addisonian crisis being the presenting manifestation of underlying malignant tumors of the lung, colon, or lymphomas [11]. One also needs to be aware of the possibility of malignancy as a differential in cases presenting as adrenal insufficiency.…”

Section: Discussionmentioning

confidence: 99%

Gastric malignancy presenting as adrenal insufficiency: A case report

Tevethia¹,

Baskaran²,

Kadavanu³

et al. 2013

IJCRI

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Introduction: carcinomas in the lung, breast, and lymphomas are known to metastasize to the adrenal gland. However, these metastases initially do not present with signs and symptoms of adrenal insufficiency leading to a decreased chance of adrenal insufficiency being diagnosed. We report a case of adrenal insufficiency due to bilateral adrenal metastases as the presenting manifestation of gastric carcinoma. case report: A 72-year-old male was admitted to our hospital due to altered mental status, weakness, anorexia, hematemesis and urinary incontinence for three days. Hyponatremia, hyperkalemia, anemia, and mild metabolic acidosis were detected. A diagnosis of gastric carcinoma along with bilateral metastases of the adrenal glands was made after biopsy computed tomography and positron emission tomography scans. Initiation of mineralocorticoid replacement therapy, improved the condition of patient. conclusion: there are only a few reports of adrenal insufficiency or true Addisonian crisis being the

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Gastric carcinoma presenting with adrenal insufficiency caused by bilateral adrenal metastasis

Cited by 6 publications

References 0 publications

Adrenal insufficiency due to bilateral adrenal metastases – A systematic review and meta-analysis

Adrenal insufficiency due to bilateral adrenal metastases – A systematic review and meta-analysis

Bilateral Adrenal Metastasis Presenting as Adrenal Insufficiency.

Gastric malignancy presenting as adrenal insufficiency: A case report

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