Adrenal hemorrhage secondary to metastasis from lung cancer

The adrenals are common metastatic sites for lung cancers as well as a number of other primary cancers. Usually these metastases are asymptomatic. Hemorrhagic adrenal metastases from lung cancer are extremely rare. Only 5 prior reports of hemorrhagic adrenal metastases from lung cancer have appeared in the English literature. We report a case of spontaneous, massive, adrenal hemorrhage secondary to metastatic lung cancer in a 62-year-old patient. In lung cancer, patients with sudden onset of pain in the flank or back in association with anemia and hypotension, adrenal hemorrhage secondary to metastatic disease should be considered in the differential diagnosis. Computed tomography scans and magnetic resonance imaging aid in confirming the diagnosis.