Adrenal insufficiency: An uncommon presentation of non-small cell lung cancer

Metastasis to the adrenal gland has been observed in several malignancies; however, adrenal insufficiency as the presenting sign seems rare in these patients. This is a case of a patient presenting with nausea, vomiting, generalized fatigue, and hyponatremia. CT scan demonstrated left upper lobe opacity and bilateral adrenal masses. A biopsy of the adrenal gland revealed non-small cell lung cancer (NSCLC) with metastatic involvement of the adrenal glands. The non-specific symptoms and relative adrenal insufficiency in patients with lung masses should heighten the suspicion for metastatic involvement of the adrenals.