Adrenal insufficiency caused by bilateral adrenal macrometastases: A rare case with metastatic colon cancer

İrfan Çiçin; Sernaz Uzunoğlu; Hakan Karagöl; Ufuk Usta; Osman Temizöz; Nilay Ermantaş

Metastatik kolon kanserli bir olguda adrenal yetmezlik

Year 2008, Volume: 23 Issue: 2, 96 - 99, 01.03.2008

İrfan Çiçin Sernaz Uzunoğlu Hakan Karagöl Ufuk Usta Osman Temizöz Nilay Ermantaş

Abstract

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

Male, Adult, Adrenal Insufficiency, Colonic Neoplasms, Neoplasm Metastasis, Adenocarcinoma, Biopsy

References

1) Lutz A, Stojkovic M, Schmidt M, Arlt W, Allolio B, Reincke M. Adrenocortical function in patients with macrometastases of the adrenal gland. Eur J Endocrinol 2000;143(1):91-7
2) Kung AW, Pun KK, Lam K, Wang C, Leung CY. Addisonian crisis as presenting feature in malignancies. Cancer 1990;65(1):177-9
3) Redman BG, Pazdur R, Zingas AP, Loredo R. Prospective evaluation of adrenal insufficiency in patients with adrenal metastasis. Cancer 1987;60(1):103-7
4) Seidenwurm DJ, Elmer EB, Kaplan LM, Williams EK, Morris DG, Hoffman AR. Metastases to the adrenal glands and the development of Addison's disease. Cancer 1984;54(3):552-7
5) Oelkers W. Adrenal insufficiency. N Engl J Med 1996;335(16):1206-12
6) Cedermark BJ, Sjöberg HE. The clinical significance of metastases to the adrenal glands. Surg Gynecol Obstet 1981;152(5):607-10

Adrenal insufficiency caused by bilateral adrenal macrometastases: A rare case with metastatic colon cancer

Year 2008, Volume: 23 Issue: 2, 96 - 99, 01.03.2008

İrfan Çiçin Sernaz Uzunoğlu Hakan Karagöl Ufuk Usta Osman Temizöz Nilay Ermantaş

Abstract

Kilo kaybı, halsizliği, hipotansiyonu, hiponatremi ve hipoglisemi şikayetleri olan 42 yaşında erkek hasta hastanemize sevkedildi. Karın ve pelvis bilgisayarlı tomografisinde karaciğerde çok sayıda solit kitle, sigmoid kolon duvarında kalınlaşma ve sağda 7x5x3 cm, solda 6x4,5x3,5 cm boyutlarında olmak üzere iki taraflı sürrenal kitleler gözlendi. Kolonoskopik muayenede sigmoid kolondan kaynaklanan tümöral kitle görüldü. Biyopsi yapıldı ve adenokarsinom tanısı kondu. Hastada iki taraflı adrenal makrometastazlara bağlı primer sürrenal yetmezliği düşünüldü. Sürrenal yetmezlik tanısı serum ACTH ve kortizol değerleri ve ACTH uyarı testi ile doğrulandı. Kanser hastalarında sürrenal yetmezlik iyi tanımlanmıştır, fakat sürrenal metastaz sıklığı ile karşılaştırıldığında sürrenal yetmezliği nadir görülmektedir. Bu yazıda, kolon kanserinde nadir görülen iki taraşı sürrenal makrometastazı olan ve buna bağlı sürrenal yetmezliği gelişen bir olgu sunuldu.

Keywords

Kolon kanseri, sürrenal metastaz, sürrenal yetmezliği

References

1) Lutz A, Stojkovic M, Schmidt M, Arlt W, Allolio B, Reincke M. Adrenocortical function in patients with macrometastases of the adrenal gland. Eur J Endocrinol 2000;143(1):91-7
2) Kung AW, Pun KK, Lam K, Wang C, Leung CY. Addisonian crisis as presenting feature in malignancies. Cancer 1990;65(1):177-9
3) Redman BG, Pazdur R, Zingas AP, Loredo R. Prospective evaluation of adrenal insufficiency in patients with adrenal metastasis. Cancer 1987;60(1):103-7
4) Seidenwurm DJ, Elmer EB, Kaplan LM, Williams EK, Morris DG, Hoffman AR. Metastases to the adrenal glands and the development of Addison's disease. Cancer 1984;54(3):552-7
5) Oelkers W. Adrenal insufficiency. N Engl J Med 1996;335(16):1206-12
6) Cedermark BJ, Sjöberg HE. The clinical significance of metastases to the adrenal glands. Surg Gynecol Obstet 1981;152(5):607-10

There are 6 citations in total.

Details

Primary Language	Turkish
Journal Section	Articles
Authors	İrfan Çiçin This is me Sernaz Uzunoğlu This is me Hakan Karagöl This is me Ufuk Usta This is me Osman Temizöz This is me Nilay Ermantaş This is me
Publication Date	March 1, 2008
Published in Issue	Year 2008 Volume: 23 Issue: 2

Cite

APA	Çiçin, İ., Uzunoğlu, S., Karagöl, H., Usta, U., et al. (2008). Adrenal insufficiency caused by bilateral adrenal macrometastases: A rare case with metastatic colon cancer. Türk Onkoloji Dergisi, 23(2), 96-99.
AMA	Çiçin İ, Uzunoğlu S, Karagöl H, Usta U, Temizöz O, Ermantaş N. Adrenal insufficiency caused by bilateral adrenal macrometastases: A rare case with metastatic colon cancer. Türk Onkoloji Dergisi. March 2008;23(2):96-99.
Chicago	Çiçin, İrfan, Sernaz Uzunoğlu, Hakan Karagöl, Ufuk Usta, Osman Temizöz, and Nilay Ermantaş. “Adrenal Insufficiency Caused by Bilateral Adrenal Macrometastases: A Rare Case With Metastatic Colon Cancer”. Türk Onkoloji Dergisi 23, no. 2 (March 2008): 96-99.
EndNote	Çiçin İ, Uzunoğlu S, Karagöl H, Usta U, Temizöz O, Ermantaş N (March 1, 2008) Adrenal insufficiency caused by bilateral adrenal macrometastases: A rare case with metastatic colon cancer. Türk Onkoloji Dergisi 23 2 96–99.
IEEE	İ. Çiçin, S. Uzunoğlu, H. Karagöl, U. Usta, O. Temizöz, and N. Ermantaş, “Adrenal insufficiency caused by bilateral adrenal macrometastases: A rare case with metastatic colon cancer”, Türk Onkoloji Dergisi, vol. 23, no. 2, pp. 96–99, 2008.
ISNAD	Çiçin, İrfan et al. “Adrenal Insufficiency Caused by Bilateral Adrenal Macrometastases: A Rare Case With Metastatic Colon Cancer”. Türk Onkoloji Dergisi 23/2 (March 2008), 96-99.
JAMA	Çiçin İ, Uzunoğlu S, Karagöl H, Usta U, Temizöz O, Ermantaş N. Adrenal insufficiency caused by bilateral adrenal macrometastases: A rare case with metastatic colon cancer. Türk Onkoloji Dergisi. 2008;23:96–99.
MLA	Çiçin, İrfan et al. “Adrenal Insufficiency Caused by Bilateral Adrenal Macrometastases: A Rare Case With Metastatic Colon Cancer”. Türk Onkoloji Dergisi, vol. 23, no. 2, 2008, pp. 96-99.
Vancouver	Çiçin İ, Uzunoğlu S, Karagöl H, Usta U, Temizöz O, Ermantaş N. Adrenal insufficiency caused by bilateral adrenal macrometastases: A rare case with metastatic colon cancer. Türk Onkoloji Dergisi. 2008;23(2):96-9.