Production of cortisol is controlled by the action of ACTH produced
pituitary gland. The pituitary gland is regulated by
hypothalamus in the brain. If either the
hypothalamus or pituitary gland is damaged, less ACTH
is produced, leading to underfunctioning of the adrenal glands and reduced
Incidence and Mortality
Estimated new cases and deaths from renal cell (kidney and renal pelvis) cancer in the United States in 2013:
New cases: 65,150.
Renal cell cancer, also called renal adenocarcinoma, or hypernephroma, can often be cured if it is diagnosed and treated when still localized to the kidney and to the immediately surrounding tissue. The probability of cure is directly related to the stage or degree of tumor dissemination. Even when regional lymphatics...
Previous radiation of the hypothalamus or pituitary
Previous surgery to the pituitary gland.
conditions such as
sarcoidosis, or Sheehan's syndrome (hypopituitarism).
Sheehan's syndrome is occasionally caused by severe blood loss after delivering
The symptoms of secondary adrenocortical insufficiency are similar to
Addison's disease, except that darkening of the skin
(hyperpigmentation) and high levels of potassium in the blood are not present.
With secondary adrenocortical insufficiency, only cortisol is low.
The adrenal glands can still make normal amounts of aldosterone. Symptoms
Fatigue and muscle weakness that gradually become
worse over time.
Diagnosis starts with a medical history and physical examination. If
your doctor suspects adrenal insufficiency, he or she will check your blood
cortisol and ACTH levels. Your doctor may recommend imaging tests of the
adrenal glands, the pituitary gland, or the hypothalamus.
If your doctor suspects secondary adrenocortical insufficiency, you
may get infusions of ACTH on two consecutive days. In most cases, even if you
have problems with the
adrenal glands will make cortisol by the end of the
second treatment. If possible, your doctor will treat the condition that is
causing secondary adrenocortical insufficiency. Your doctor may start treatment
during the testing if he or she thinks adrenal insufficiency is likely. If
treatment is found to be unnecessary, it can be stopped after testing is
CT scan or
MRI can be used to see
whether there is evidence of damage to the brain or pituitary gland (such as a
tumor) that is causing adrenal failure.
In this article
This information is produced and provided by the National
Institute (NCI). The information in this topic may have changed since it was written. For the most current information, contact the National
Institute via the Internet web site at http://
.gov or call 1-800-4-CANCER.
WebMD Medical Reference from Healthwise
November 08, 2013
This information is not intended to replace the advice of a doctor.
Healthwise disclaims any liability for the decisions you make based on this