Addison's Disease Due to Reticulum‐cell Sarcoma Apparently Confined to the Adrenals

A bstract A 71‐year‐old diabetic white male was admitted with weakness, weight loss, fever, gastrointestinal symptoms, and postural hypotension. At first he was treated with digitalis and diuretics for congestive heart failure. However, he became worse and increasing signs of adrenal insufficiency appeared although there was no hyperpigmentation. Urinary steroid values before and after administration of ACTH, and the responses to fluorohydrocortisone and cortisone acetate supported the diagnosis of Addison's disease. After initial improvement, myocardial infarction, vasomotor collapse and pneumonia intervened. Despite increased dosages of steroids and the administration of antibiotics, oxygen and vasopressors, the patient died. At necropsy, the adrenals were found to be completely replaced by reticulum‐cell sarcoma. The tumor had invaded the upper pole of both kidneys, but no tumor tissue was found in the lymph nodes or in any other location. Presumably the tumor arose within the adrenals.