Emília MOJTOVÁ1, Jana HANAJÍKOVÁ2, Daniel DYTTERT3, Iveta WACZULÍKOVÁ4, Marianna GRIGEROVÁ1, Ján PODOBA1

1Klinika endokrinológie LF SZU a OÚSA, Bratislava, prednosta doc. MUDr. J. Podoba, CSc.
2II. rádiologická klinika LF UK a OÚSA, Bratislava, prednostka doc. MUDr. V. Lehotská, PhD.
3Klinika onkologickej chirurgie LF UK a OÚSA, Bratislava, prednosta prof. MUDr. Š. Durdík, PhD., MHA
4Katedra jadrovej fyziky a biofyziky, Fakulta matematiky, fyziky a informatiky UK, Bratislava, dekan prof. RNDr. D. Ševčovič, DrSc.

SUMMARY
Background: In the available literature, there is no clinical study conducted in a larger number of patients with adrenal metastases (mts) with an emphasis on adrenal insufficiency. Our aim was to detect the incidence of adrenal insufficiency in patients with generalized malignancy.

Patients and methods: We examined blood ACTH and cortison concentrations in 31 patients with adrenal mts, 13 patients with unilateral mts, and 18 patients with bilateral mts. The results were correlated with imaging examination (tumor type, bilateral involvement, size of mts).
Results: In the group with unilateral mts, we did not confirm any case of adrenal insufficiency. In the group with bilateral mts, adrenal insufficiency occurred in two cases (11.1 %). At the same time, we found out that the ACTH level correlated positively with the mts size. The cortisol level correlated with the mts size negatively, but this relationship was not statistically significant.
Conclusion: In the group with bilateral mts, adrenal insufficiency was detected in two cases (11.1 %). We confirmed the hypothesis that the risk of adrenal insufficiency increases with the size of mts and is associated only with bilateral metastatic involvement.
Key words: adrenal insufficiency, adrenal metastases, ACTH, cortisol, replacement therapy.

Lek Obz (Med Horizon), 2020, 69 (3): 73 – 78