ADRENOCORTICAL CANCER WITH UNDULATING FEVER IN ADDISON'S DISEASE

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Abstract
THE following observation helps us to elucidate certain points in the natural history of Addison's disease, particularly the rôle of adrenocortical cancer in the genesis of this disease and the significance of undulating pyrexia in the Addisonian clinical picture. CLINICAL OBSERVATION G. P., 34-year-old male, was observed principally during the first four months of 1945. His whole history can be divided into five phases, (a) a prodromic phase: (b) a phase of onset of distinct symptoms, (c) a phase of severe Addisonian crisis, (d) a phase of subacute Addisonism, and (e) a terminal phase of Addisonian coma. Personality, constitution. The patient was a Greek from the Greek islands. There was nothing particular in his heredity nor in his previous history save for an appendectomy done in 1940. He complained at that time of vomiting and pains. The appendix showed chronic lesions. Physically he was a “pycnic,” brevilinear, of normal stature, muscularly powerful, violent and a little aggressive. He had a tendency to overweight, weighing more than 12 stone in 1943. His blood pressure, taken during a health examination in 1940, was 100/70. His blood group was O. In his early youth he had joined the Merchant Navy and had travelled extensively. He was successful in business, active and extrovert, keen on amusing himself and gambling. He was happily married, but his wife and child were cut off from him, as they were in Athens during the occupation of Greece, and this worried him intensely. He was rather hypersexual but not a heavy smoker nor drinker.

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