Adrenal Hormones and Disorders
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Abstract
Abstract
Background: Primary adrenal tuberculosis is a rare clinical entity and an uncommon cause of Addison's disease.While adrenal tuberculosis is usually secondary to pulmonary or genitourinary tuberculosis, isolated primary adrenal involvement without evidence of disease elsewhere is exceptionally rare. Case presentation:We report the case of a 46-year-old male who presented with generalized weakness and disorientation.Laboratory investigations revealed markedly elevated adrenocorticotropic hormone (ACTH) levels and profoundly low morning cortisol, consistent with primary adrenal insufficiency.Contrast-enhanced CT abdomen demonstrated a right adrenal mass suggestive of a non-functional adrenal adenoma.The patient underwent right adrenalectomy; however, histopathology revealed caseous necrosis and necrotizing granulomatous lymphadenitis consistent with tuberculosis.No evidence of extra-adrenal tuberculosis was identified, confirming the diagnosis of primary adrenal tuberculosis.The patient was managed with lifelong hormone replacement therapy (hydrocortisone and fludrocortisone) and a 12-month course of antituberculous therapy. Conclusion:This case highlights the diagnostic challenges of adrenal tuberculosis presenting as an adrenal mass.It underscores the importance of considering infectious etiologies, particularly tuberculosis, in the differential diagnosis of adrenal lesions in endemic regions.
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@article{Tayong2026Primary,
title = {Primary Adrenal Tuberculosis Masquerading as Adrenal Adenoma: A Rare Cause of Addison’s Disease},
author = {Felicita M Tayong and Anwar Hayat and Syed Usman Husain Shah and Muhammad Waseem and Aysha Habib and Fareeha Afroz and Tauseef Ali and Tanzeela Shah and Arshad Ali and Hamayal Khan and Ayaz Ali and Shawal Noor},
journal = {Medical & Clinical Case Reports Journal},
year = {2026},
doi = {10.51219/mccrj/ayaz-ali/467},
url = {https://doi.org/10.51219/mccrj/ayaz-ali/467}
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