Case 630 -- A fifty-year-old male with muscle weakness and hypokalemia

Contributed by Shveta Hooda MD and Mohamed A.Virji MD, PhD


A fifty year old male with a history of metastatic prostate cancer was admitted with chief complaints of generalized weakness and headache.

Lab Results for Admission # 1:

The patient was treated with K+ replacement and PRBC transfusion and subsequently discharged. The patient was admitted again a week later with the chief complaints of generalized weakness and shortness of breath.

MRI imaging of brain and thoracic spine showed widespread osseous metastatic disease. CT abdomen revealed high grade small-bowel obstruction as well as nodular thickening of both the adrenal glands.

The patient was diagnosed with bilateral nodular adrenal hyperplasia. He was found to have a new onset hypertension with the blood pressure of 160/97 mm Hg.

Lab Results for Admission # 2:


High Grade Prostatic Adenocarcinoma, acinar type with neuroendocrine differentiation, Gleason score of 9


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