Adrenal metastasis from renal cell carcinoma: significance of adrenalectomy.
BACKGROUND
The present study examined adrenal metastasis resulting from renal cell carcinoma (RCC), with the aim of assessing the need for routine ipsilateral adrenalectomy during radical nephrectomy.


METHODS
Ipsilateral and contralateral adrenal metastases were investigated in 256 patients with RCC who had undergone radical nephrectomy from 1977 to 1996 at the Tohoku University School of Medicine.


RESULTS
Twelve of the 256 patients (4.7%) had adrenal metastasis. Ten of these 12 patients had progressed to disseminated disease with very poor prognosis. Two patients who had solitary adrenal metastases remained disease-free for 21 and 7 years. Four patients showed metastases to the contralateral adrenal gland. Adrenal metastases in seven of 12 patients were identified by pre- or postoperative computed tomography (CT), and in another five macroscopically during surgery.


CONCLUSIONS
Adrenalectomy was regarded as a possible curative treatment for patients with solitary adrenal metastasis. However, the incidence of this kind of metastasis was minimal and contralateral adrenal metastases may occur in RCC cases. We therefore believe that adrenalectomy should only be performed if radiographic evidence reveals metastases in the adrenal gland or if gross disease is present at the time of nephrectomy.
Ito
Akihiro
A
Department of Urology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aobaku, Sendai 980-8574, Japan.
Satoh
Makoto
M
Ohyama
Chikara
C
Saito
Seiichi
S
Shintaku
Ichiro
I
Nakano
Osamu
O
Aoki
Hiroshi
H
Hoshi
Senji
S
Orikasa
Seiichi
S
D000310:Adrenal Gland Neoplasms / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D000315:Adrenalectomy / Q000401:mortality; D000368:Aged; D002292:Carcinoma, Renal Cell / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D006801:Humans; D007680:Kidney Neoplasms / Q000401:mortality / Q000473:pathology*; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D015996:Survival Rate