An acute adrenal insufficiency revealing pituitary metastases of lung cancer in an elderly patient

  • Hela Marmouch
  • Sondes Arfa
  • Saoussen Cheikh Mohamed
  • Tensim Slim
  • Ines Khochtali

Abstract

Metastases of solid tumors to the pituitary gland are often asymptomatic or appereas as with diabetes insipid us. Pituitary metastases more commonly affect the posterior lobe and the infundibulum than the anterior lobe. The presentation with an acute adrenal insufficiency is a rare event. A 69-year-old men presented with vomiting, low blood pressure and hypoglycemia. Hormonal exploration confirmed a hypopituitarism. Appropriate therapy was initiated urgently. The hypothalamic-pituitary MRI showed a pituitary hypertrophy, a nodular thickening of the pituitary stalk. The chest X Rays revealed pulmonary opacity. Computed tomography scan of the chest showed a multiples tumors with mediastinal lymphadenopathy. Bronchoscopy and biopsy demonstrated a pulmonary adenocarcinoma. Hence we concluded to a lung cancer with multiple pituitary and adrenal gland metastases. This case emphasizes the need for an etiological investigation of acute adrenal insufficiency after treatment of acute phase.

Pan African Medical Journal 2016; 23

Author Biographies

Hela Marmouch
Department of Endocrinology and Internal Medecine, Fattouma Bourguiba University Hospital, Monastir, Tunisia
Sondes Arfa
Department of Endocrinology and Internal Medecine, Fattouma Bourguiba University Hospital, Monastir, Tunisia
Saoussen Cheikh Mohamed
Department of Pneumology, Fattouma Bourguiba University Hospital, Monastir, Tunisia
Tensim Slim
Department of Endocrinology and Internal Medecine, Fattouma Bourguiba University Hospital, Monastir, Tunisia
Ines Khochtali
Department of Endocrinology and Internal Medecine, Fattouma Bourguiba University Hospital, Monastir, Tunisia
Published
2016-06-13
Section
Articles

Journal Identifiers


eISSN: 1937-8688