Adrenal insufficiency due to metastatic hepatocellular carcinoma

A 73-year-old man with general malaise and nausea following a common cold d iagnosed by a local physician was found to have multiple hepatocellular car cinomas with enlarged bilateral adrenal glands, combined with adrenal insuf ficiency. Hydrocortisone replacement improved the symptoms and laboratory f indings. Autopsy findings revealed that each adrenal gland was completely r eplaced by the tumor measuring 11 cm in diameter, and no adrenal tissue was recognized. Histologically, the adrenal tumors, as well as the liver tumor s, were moderately differentiated Edmondson type II hepatocellular carcinom as. This is a second report of adrenal insufficiency due to hepatocellular carcinoma as a primary site of metastatic adrenal tumor.