An upper gastrointestinal endoscopy was normal, and a nasojejunal tube was inserted. Two months before admission, chest radiography showed signs of chronic obstructive pulmonary disease, micronodules and linear opacities in the upper lobes, and a small consolidation in the lower left lobe. Other aspects of his physical examination were normal. There were several lymph nodes the cervical region, the larger one with 1.5 cm, and digital clubbing. His physical examination revealed an alert, oriented man, with blood pressure: 120/70 mmHg heart rate: 72 bpm respiratory rate: 20 rpm axillary temperature: 36☌ pulse oximetry: 95% weight: 33.5 kg height: 1.53 m BMI: 14.3 kg/m 2.
His brother died of esophageal cancer with 55 years old. His father died of sudden death at 83 years old, and his mother died of stroke at 80 years old. He was taking hydrochlorothiazide 25 mg, simvastatin 20 mg, and acetylsalicylic acid 100 mg, once a day and captopril 50 mg TID. He had presented three no disabling ischemic strokes. He had arterial hypertension, type 2 diabetes mellitus with HbA1c: 6.5% one month earlier and mild chronic obstructive pulmonary disease. He was an active smoker that had smoked 100 pack-years. When he tried to eat, he felt nausea and sometimes vomited. In the last 4 months, he had anorexia, asthenia, and difficulty to swallow any food. Case ReportĪ 69-year-old man was admitted to a hospital in the South of Brazil, with weight loss, weakness, and difficulty to swallow. Lung cancer is commonly associated with adrenal metastasis, but few reports show association with adrenal insufficiency. Other causes include adrenal destruction by infections such tuberculosis and fungal disease or cancer metastatic infiltration. IntroductionĪdrenal failure is a rare condition, and the most common cause is autoimmune adrenalitis. We review the differential diagnosis of weight loss and how to make diagnosis of adrenal insufficiency. This is a rare presentation of lung cancer. We report a case of a patient with adrenal failure due to bilateral adrenal metastasis of lung cancer.
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