ADRENAL INSUFFICIENCY PRODUCED BY METASTASES FROM GASTRIC CARCINOMA

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Abstract
Metastatic carcinoma in the adrenals is fairly common, but patients usually die before the adrenal lesions become sufficiently destructive to produce symptoms of adrenal insufficiency. While lung carcinoma is the primary lesion which most frequently produces adrenal metastases and has caused the greatest number of reported cases of Addison''s disease, gastric carcinoma has been recorded as causing adrenal insufficiency 4 times since 1900, and the present case adds a fifth. The patient showed skin pigmentation and hypotension. 24 hour urinary 17 ketosteroids were 1.4 mg; the eosinophil count did not fall after epinephrine. The autopsy records of the Solders'' Home Hospital for the years 1950- 1954 show 3 other cases of massive bilateral adrenal destruction in 82 cases of carcinoma, and thus suggest that more cases of adrenal insufficiency caused by metastatic carcinoma would be uncovered if studies of adrenal function were undertaken more frequently.