title: [Long course metastasis in renal adenocarcinoma. Adrenal gland involvement].
abstract: OBJECTIVE
  To report two cases of metachronic adrenal metastasis (one contralateral and the other bilateral) from renal cell carcinoma with long survival.
  
  
  METHODS
  Two patients with clear cell renal carcinoma that developed metastasis to the adrenals are described. Each patient had undergone three operations for solitary metastasis during the 8-years follow-up. The indications for the surgical management of solitary metastasis, morbidity, prognosis and recent investigational treatment possibilities reported in the literature are analyzed.
  
  
  RESULTS
  Resection of the renal cell carcinoma achieved a survival of more than 8 years with a good quality of life and no significant surgical complications. The outcome, however, is poor.
  
  
  CONCLUSIONS
  Although there was no lymph node involvement and the tumor was localized to the renal parenchyma, one patient developed solitary lung metastasis and contralateral adrenal metastasis 4 and 8 years after the initial diagnosis, respectively. In the other case, contralateral adrenal metastasis appeared three years later. The possibility of long-term metastasis to the adrenal gland should be taken into account due to renal vein involvement. Preservation of the adrenal gland at the initial surgery (lower pole tumor) led to adrenal metastasis 8 years after the initial diagnosis. The prognosis is poor in both cases and the situation is discouraging for the urologist.
authors.affiliation: Hospital General Universitario de Elche, Alicante, España.
authors.forename: E
authors.initials: E
authors.lastname: de Nova Sánchez
authors.forename: L
authors.initials: L
authors.lastname: Prieto Chaparro
authors.forename: J A
authors.initials: JA
authors.lastname: Galán Llopis
authors.forename: F
authors.initials: F
authors.lastname: Lloréns Martínez
authors.forename: C
authors.initials: C
authors.lastname: Fernández Puentes
authors.forename: V
authors.initials: V
authors.lastname: Menéndez López
authors.forename: F
authors.initials: F
authors.lastname: García López
mesh_terms: D000230:Adenocarcinoma / Q000556:secondary*; D000310:Adrenal Gland Neoplasms / Q000556:secondary*; D000328:Adult; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology*; D008875:Middle Aged; D013997:Time Factors