Addisonian crisis as presenting feature in malignancies.

Metastases to the adrenal glands are common in patients with malignancy but malignant disease presenting as Addisonian crisis is rare. The authors presented two patients with acute Addisonian crises due to metastatic infiltration of the adrenal glands. They were otherwise asymptomatic from the primary tumor. Computed tomographic scan showed bilateral adrenal enlargement and transcutaneous biopsy confirmed metastatic adenocarcinoma in the adrenals. Adequate glucocorticoid replacement improves quality of life and prolongs survival.