A function and carcinoma of the lung is suggested by the following observations: (1) Bronchogenic carcinoma has a predilection for metastasizing to the adrenal glands and occasionally causes adrenal insufficiency.l1,*1,41 (2) In autopsy studies, an increased incidence of adrenocortical hyperplasia has been noted in patients with carcinoma of the lung.26094 (3) Adrenocortical hyperfunction has been observed in association with carcinoma of the lung and to date 19 such cases have been reported or mentioned.2-6.12, 16-17,19, 22,23.28, 29. 86, 86, 40 Our interest in this relationship was stimulated when we discovered a patient with bronchogenic carcinoma who had elevated plasma and urinary 17-hydroxycorticosteroid (1 7-OHCS) levels without clinical manifestations of Cushing's syndrome or hyperaldosteronism. Autopsy revealed the presence of bilateral adrenal hyperplasia. A report of this case follows:
REPORT OF A CASE R.S., a 65-year-old white retired factory worker, was admitted to the Veterans Administration Hospital, Cincinnati, Ohio, on April 15, 1957, with the presumptive diagnosis of carcinoma of the lung and mental depression. The patient was confused and responded poorly to questioning. His wife stated that he had developed progressive weakness, forgetfulness, and depression and had had a 25-lb. weight loss over the previous 6 to 9 months. During the 3 weeks prior to admission he had anorexia and recurrent vomiting. One year previously he had experienced some breath-From the