Case Presentation: A 66-year-old female with a history of stage IV non-small cell lung cancer (NSCLC) (90% PD-L1 +) on pembrolizumab (status post cycle 9) with metastasis to the left adrenal gland presented with a two-week history of malaise, nausea, and vomiting. Vital signs were stable and physical exam was euvolemic, with mild epigastric tenderness. […]