Rare cause of adrenal insufficiency

Justin Ws Hii; Michael M Page; Andrew Wesseldine

doi:10.1136/bcr-2016-219136

Rare cause of adrenal insufficiency

BMJ Case Rep. 2017 Nov 16:2017:bcr2016219136. doi: 10.1136/bcr-2016-219136.

Authors

Justin Ws Hii^{1

2}, Michael M Page³, Andrew Wesseldine¹

Affiliations

¹ Department of Geriatrics and General Medicine, St John of God Hospital, Subiaco, Western Australia, Australia.
² Department of Anaesthesia and Pain Medicine, Fiona Stanley Hospital, Murdoch, Western Australia, Australia.
³ Department of Clinical Biochemistry, PathWest, Fiona Stanley Hospital, Murdoch, Western Australia, Australia.

Abstract

A 72-year-old man presented with weight loss, night sweats and haemoptysis and was hypotensive. CT imaging showed rapidly enlarging bilateral adrenal masses, and he was found to have primary adrenal insufficiency. An adrenal gland biopsy revealed the rare diagnosis of primary adrenal lymphoma. This unique case highlights possible rare causes of adrenal masses and adrenal insufficiency, their investigation and management principles.

Keywords: adrenal disorders; endocrinology; haematology (incl blood transfusion).

Publication types

Case Reports

MeSH terms

Addison Disease / complications
Addison Disease / diagnosis*
Addison Disease / diagnostic imaging
Addison Disease / drug therapy
Adrenal Gland Neoplasms / complications
Adrenal Gland Neoplasms / diagnosis*
Adrenal Gland Neoplasms / diagnostic imaging
Adrenal Gland Neoplasms / drug therapy
Aged
Antineoplastic Combined Chemotherapy Protocols
Cyclophosphamide
Diagnosis, Differential
Doxorubicin
Humans
Hypotension / etiology
Lymphoma / complications
Lymphoma / diagnosis*
Lymphoma / diagnostic imaging
Lymphoma / drug therapy
Male
Positron-Emission Tomography
Prednisolone
Tomography, X-Ray Computed
Vincristine
Weight Loss

Substances

Vincristine
Doxorubicin
Cyclophosphamide
Prednisolone

Supplementary concepts

VAP-cyclo protocol