title: Bilateral metachronous adrenal metastases of operated renal cell carcinoma.
abstract: BACKGROUND
  The adrenal glands are among the target metastatic organs due to the potential of systemic metastasis from renal cell carcinoma (RCC). The number of cases with bilateral metachronous metastases from RCC is about twenty.
  
  
  METHODS
  A sixty-one-year-old man presented for routine checks due to an operated left renal tumor (clear cell carcinoma, PT2N0M0, Fuhrman grade III). The patient underwent 18FDG-PET/CT in order to re-stage the disease upon observation of bilateral adrenal masses on ultrasound and CT. A bilateral metachronous metastasis was found, whose SUVmax was 6.7 x 50 x 38 x 20 cm on the left adrenal gland, and another metastasis whose SUVmax was 5.5 40 x 29 x 20 on the right adrenal gland.
  
  
  RESULTS
  The patient underwent a CT-guided biopsy and diagnosis of adrenal metastasis was made by pathological and immunohistochemical examination. The laparoscopic treatment was performed.
  
  
  CONCLUSIONS
  There is no standard approach for the treatment of these patients in the literature. But metastasectomy is the most realistic part of the treatment. Making definitive diagnosis with biopsy, following hormonal examination and treatment with minimally invasive adrenal sparing surgical procedure containing frozen-section are strongly recommended. Cancer specific survival significantly increases with metastasectomy.
authors.affiliation: 1 Department of Urology, School of Medicine, Sifa University, Izmir - Turkey.
authors.forename: Hakan
authors.initials: H
authors.lastname: Ozturk
authors.forename: Inanç
authors.initials: I
authors.lastname: Karapolat
authors.forename: Ali
authors.initials: A
authors.lastname: Saklamaz
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary* / Q000601:surgery*; D000315:Adrenalectomy / Q000379:methods; D002292:Carcinoma, Renal Cell / Q000000981:diagnostic imaging / Q000556:secondary* / Q000601:surgery*; D019788:Fluorodeoxyglucose F18 / Q000494:pharmacology; D006801:Humans; D061705:Image-Guided Biopsy; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000000981:diagnostic imaging / Q000601:surgery*; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods; D015641:Radiography, Interventional; D019275:Radiopharmaceuticals / Q000494:pharmacology; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18