Metachronous adrenal metastasis from contralateral renal cell carcinoma (RCC) surgery is an extremely rare condition. Iatrogenic Addison's disease occurring after metastasectomy (adrenalectomy) is an even rarer clinical entity. We present a case of a 68-year-old male with hematuria and left flank pain 9 years prior. The patient underwent left transperitoneal radical nephrectomy involving the ipsilateral adrenal glands due to a centrally-located, 75-mm in diameter solid mass lesion in the upper pole of the left kidney. The tumour lesion was confined within the renal capsule, and the histopathological examination revealed a Fuhrman nuclear grade II clear cell carcinoma. The patient underwent transperitoneal right adrenalectomy. The histopathological examination revealed metastasis of clear cell carcinoma. The patient was diagnosed with iatrogenic Addison's disease based on the measurement of serum cortisol levels and the adrenocorticotropic hormone (ACTH) stimulation test, after which glucocorticoid and mineralocorticoid replacement was initiated. The patient did not have local recurrence or new metastasis in the first year of the follow-up. The decision to perform ipsilateral adrenalectomy during radical nephrectomy constitutes a challenge, and the operating surgeon must consider all these rare factors.

Idiopathic lobular granulomatous mastitis (ILGM) is a relatively rare disease in women during reproductive life and may commonly mimic carcinoma. Histopathology is the most definitive method of diagnosis. Herein, we report three cases who had very similar clinical-radiological findings to malignancy. None of the women has systemic disorder or history of a specific infection. All lesions were widely excised. Histopathological investigation revealed a lobular, non-caseating granulomatous inflammation. Clinicians should consider the possibility of idiopathic granulomatous mastitis in young women with clinical and radiological findings which are similar to malignancy of breast lesions.