Adrenal failure and orchitis secondary to tuberculosis mimicking metastatic malignancy

Primary adrenal insufficiency, a potentially life-threatening disease, often runs an insidious course mandating a strong clinical suspicion for a prompt diagnosis.1 A 65-year-old farmer presented with a one-month history of fatigue and dizziness reporting episodes of loss of consciousness. On clinical examination, he appeared cachectic, with skin and mucosal hyperpigmentation. Chest computed tomography, subsequent to a chest X-ray showing a “coin” lesion, demonstrated a 2.4 × 2cm nodule of the posterior right upper lobe and small lymph-nodes in the mediastinum.