Abstract
A 57-year-old woman underwent breast-conserving therapy for left breast cancer (T1N1M0) in February 2008. She received tamoxifen as postoperative adjuvant therapy. In March 2010, she noticed several subcutaneous tumors on her chest and back, which were histopathologically confirmed to be metastatic carcinomas. Subsequent CT examination also revealed hepatic and bilateral adrenal metastases. She was admitted to our hospital with severe vomiting and diarrhea in July 2014. These symptoms quickly improved with non-specific therapy after four days in the hospital. However, the patient presented again to our hospital with a history of loss of appetite, easy fatigability, and body weight loss of 12.6 kg over the previous two months. Addison's disease was suspected based on the observation of marked hyperpigmentation on the patient's face, hands and circumoral area. Her general condition improved dramatically with hydrocortisone replacement therapy. Adrenocorticotropic hormone (ACTH) stimulation did not increase the blood cortisol concentration. Although adrenal metastases are often detected in advanced breast cancer patients, the possibility of Addison's disease should be considered in those with bilateral metastases.
