THE CLINICAL-SIGNIFICANCE OF METASTASES TO THE ADRENAL-GLANDS

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  • 1 January 1981
    • journal article
    • research article
    • Vol. 152  (5) , 607-610
Abstract
Seven patients, 4 subsequently proved to have bilateral and 3, unilateral adrenal metastases, were evaluated regarding adrenal activity. Three of the patients had clinical signs and symptoms similar to those usually associated with manifest adrenal insufficiency. Massive tumor growth, with less than 20% residual amounts of apparently normal adrenal tissue, was found in 3 of the 4 patients with bilateral metastases. The metastases in the 4th patient were smaller and could only be detected microscopically. Evaluation of the adrenal activity included the determination of cortisol levels in plasma at 0800 h, 1400 h and 2000 h; single dose dexamethasone suppression test with ACTH stimulation, and analysis of 24 h urinary excretion of epinephrine and norepinephrine. In all 7 patients, the plasma cortisol levels, dexamethasone suppression-ACTH stimulation test results and urinary excretion of epinephrine and norepinephrine were similar to those found in comparable patients without adrenal metastases. The metastases did not seem to be of any clinically significant importance for the patients. Apparently, only minimal amounts of residual adrenal tissue are sufficient to maintain, for basic conditions, normal production of cortisol and of epinephrine and to even respond to stress.

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