Endocrine Abstracts

Introduction: Adrenal metastases due to thyroid cancers deemed to very rare as adrenal glands are not a common site of metastases from thyroid cancer. When the phenomenon occurs the prognosis is very poor as adrenal metastases usually do not fix radioactive iodine. Our aim is to report three cases.

Case reports: No. 1: a woman aged 57 harbouring anaplastic thyroid cancer classified T4, N1, M0, consulted for back pain, severe fatigue and skin pigmentation. Abdomen ultrasound showed very large tumours in both adrenals. Hormonal assessment demonstrated low cortisol with high ACTH. Although she was taking glucocorticoids at high dose, she died 1 month later after an adrenal crisis.

No. 2: a woman aged 56 was referred for oncocytic papillary carcinoma with pulmonary and bone metastases. Checking for other sites showed liver and adrenal localizations. Fine nodule aspiration of large adrenal masses confirmed the thyroid origin. More than 1 year later she is still alive, but with a large diffusion of the disease.

No. 3: a 53-year-old woman was sent for a suspect thyroid tumour. Body scan showed pulmonary, lymph nodes and bones metastases. After surgery the papillary thyroid cancer was confirmed. Some months later a right adrenal mass was discovered. She died 2 years later.

Conclusion: The 3 three women aged 53–57 have adrenal metastases from thyroid cancers. It was an anaplastic form in one case, and a papillary aggressive form in two other cases. Life duration varies from 1 month to 2 years after the adrenal metastases were diagnosed. Endocrinologist should check systematically for those metastases and trait them by surgery if they are at an early stage, if not the prognosis is poor as in our cases.