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Case Reports in Oncological Medicine
Volume 2018, Article ID 2349021, 4 pages
https://doi.org/10.1155/2018/2349021
Case Report

EGFR T790M-Positive Lung Adenocarcinoma Metastases to the Pituitary Gland Causing Adrenal Insufficiency: A Case Report

1Department of Internal Medicine, Sinai Hospital, Baltimore, MD, USA
2University of Maryland Marlene & Stewart Greenebaum Comprehensive Cancer Center, Baltimore, MD, USA
3Department of Endocrinology, Sinai Hospital, Baltimore, MD, USA

Correspondence should be addressed to Michael L. Adashek; ude.mosvw.oetso@kehsadam

Received 25 March 2018; Accepted 17 May 2018; Published 31 May 2018

Academic Editor: Giovanni Tallini

Copyright © 2018 Michael L. Adashek et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

A 64-year-old man, with history of micropapillary thyroid cancer and epidermal growth factor receptor-positive lung adenocarcinoma with no evidence of active disease for 3 years after chemotherapy and radiation on erlotinib, presented with fatigue, nausea, lack of appetite, and xeroderma. A screening magnetic resonance image of the patient’s head demonstrated a new bilateral pituitary mass. Initial evaluation revealed low morning cortisol, and the patient was diagnosed with adrenal insufficiency. His symptoms rapidly improved with maintenance glucocorticoids. Soon thereafter, the patient developed an acute visual deficit secondary to enlargement of the pituitary mass, and biopsy revealed EGFR T790M positive metastatic lung adenocarcinoma. Hence, we present a rare case of metastatic lung adenocarcinoma to the pituitary causing secondary adrenal insufficiency.