title: Long-term survival after surgical treatment of metachronous bilateral adrenal metastases of non-small cell lung carcinoma.
abstract: Background Although resection of the metastases is the treatment of choice for unilateral solitary adrenal metastasis of non-small cell lung carcinoma (NSCLC), the surgical treatment for bilateral adrenal metastases is quite rare, likely due to the coexistence of multiple synchronous metastases at other sites and/or primary adrenal insufficiency following bilateral adrenalectomy. We herein report a rare case of asynchronous metastasis of NSCLC to the bilateral adrenal glands with long-term survival after bilateral adrenalectomy. Case Report A 70-year-old male underwent right upper lobectomy for lung adenocarcinomaT2aN2M0, stageIIIA following induction chemotherapy. Forty-four months later, right adrenalectomy of a right adrenal tumor was performed, which revealed metastatic lung carcinoma. Following the administration of adjuvant chemotherapy, a metastatic tumor was detected in the left adrenal gland. Although there were no other signs of distant metastasis on radiological examinations, he underwent the chemotherapy due to the risk of adrenal insufficiency. However, on follow-up CT the adrenal lesion was found to have enlarged; therefore, left adrenalectomy was performed. Three years and six months later, he was doing well, with no evidence of recurrence. Conclusions Selected patients with solitary adrenal metastases of NSCLC can benefit from an aggressive treatment approach, even if such metastases are bilateral.
authors.affiliation: Department of General Surgery, National Hospital Organization, Okinawa National Hospital, Ginowan, Japan.
authors.forename: Naohiro
authors.initials: N
authors.lastname: Taira
authors.affiliation: Department of General Surgery, National Hospital Organization, Okinawa National Hospital, Ginowan, Japan.
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Kawabata
authors.affiliation: Department of General Surgery, National Hospital Organization, Okinawa National Hospital, Ginowan, Japan.
authors.forename: Takaharu
authors.initials: T
authors.lastname: Ichi
authors.affiliation: Department of General Surgery, National Hospital Organization, Okinawa National Hospital, Ginowan, Japan.
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Kushi
authors.affiliation: Department of General Surgery, National Hospital Organization, Okinawa National Hospital, Ginowan, Japan.
authors.forename: Tomofumi
authors.initials: T
authors.lastname: Yohena
authors.affiliation: Department of General Surgery, National Hospital Organization, Okinawa National Hospital, Ginowan, Japan.
authors.forename: Hidenori
authors.initials: H
authors.lastname: Kawasaki
authors.affiliation: Department of General Surgery, National Hospital Organization, Okinawa National Hospital, Ginowan, Japan.
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Ishikawa
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000175:diagnosis / Q000556:secondary / Q000601:surgery*; D000315:Adrenalectomy / Q000379:methods*; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis / Q000556:secondary / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D016609:Neoplasms, Second Primary; D049268:Positron-Emission Tomography; D011379:Prognosis; D013997:Time Factors; D014057:Tomography, X-Ray Computed