Abstract
We present the case of a 54-year-old woman who underwent right adrenalectomy for palliation of Cushing’s symptoms. She had recently been diagnosed with lung adenocarcinoma. Pathologic findings revealed a 5 cm adrenal adenoma with a metastatic adenocarcinoma deposit. The occurrence of tumor-to-tumor metastasis is rare, and the finding of a metastasis within a functional adrenal adenoma exceptionally so. Previously reported incidences of this finding in patients with lung cancer range from 0.14% to 0.63%. We review the literature regarding this unusual finding.
Highlights
We present the case of a 54-year-old woman who underwent right adrenalectomy for palliation of Cushing’s symptoms
Adrenal metastases likely develop via lymphatic spread in early disease and via hematogenous spread in more advanced disease
With contralateral or bilateral metastases more likely to occur with advanced disease [2]
Summary
We report on the finding of metastatic lung adenocarcinoma within a functioning adrenal adenoma which was excised for palliation of Cushing’s symptoms in a 54-year-old female. Over the preceeding two years the patient had symptoms consistent with Cushing’s syndrome with complaints of weight gain, lower extremity swelling and muscle weakness. Workup revealed an elevated free urinary cortisol (195 μg/day), suppressed ACTH (
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