[Operable lung cancer and synchronous adrenal masses: role of laparoscopic adrenalectomy combined with pulmonary resection].
OBJECTIVE
Assessment of laparoscopic adrenalectomy in the management of operable non-small cell lung cancer (NSCLC) associated with solitary and synchronous adrenal mass.


METHODS
In a retrospective study, we reviewed 3 patients with operable NSCLC proved by pulmonary biopsy and an isolated synchronous adrenal mass shown by abdominal CT scan. We first performed a laparoscopic adrenalectomy followed by pulmonary resection.


RESULTS
All patients had a laparoscopic adrenalectomy without any conversion or treatment-related death. Hospitalization stay ranged from 5 to 6 days. A left pneumonectomy has been performed immediately after this first hospitalization in 2 cases and after a first cycle of chemotherapy in the third case. Pathologic examination showed a NSCLC adrenal metastasis in 2 cases and an adrenocortical adenoma in the last case. During the follow-up 2 patients died of other distant metastasis and a mediastinal lymph node recurrence has been diagnosed in the third patient, actually treated by a second line chemotherapy.


CONCLUSIONS
Despite those bad results that concern patients T3 M+ in 2 cases, laparoscopic adrenalectomy seems to be very interesting in selected cases. Considering that pulmonary resection can be done after, it represents a mean of diagnosis at least better than fine needle aspiration biopsy. Laparoscopic adrenalectomy might also be considered in the resection of a synchronous and isolated metastasis as a way to improve survival.
Breton
X
X
Service de chirurgie viscérale et endocrinienne, CHU La Milétrie, 350, avenue Jacques-Coeur, 86021 Poitiers, France. xbreton@hotmail.com
Corbi
P
P
Faure
J P
JP
Jayle
C
C
Richer
J P
JP
Meurice
J C
JC
Tourani
J M
JM
Kraimps
J L
JL
D000310:Adrenal Gland Neoplasms / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D000315:Adrenalectomy / Q000379:methods*; D000328:Adult; D000368:Aged; D001707:Biopsy, Needle; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology* / Q000601:surgery; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008175:Lung Neoplasms / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000473:pathology / Q000601:surgery*; D016019:Survival Analysis; D016896:Treatment Outcome
Cancer bronchique opérable et lésion surrénalienne synchrone: intérêt du traitement cumulé associant surrénalectomie sous coelioscopie et exérèse pulmonaire.