Adrenalectomy for solitary adrenal metastasis from colorectal cancer: A case report

Kosmidis, Christopher; Efthimiadis, Christoforos; Anthimidis, Georgios; Levva, Sofia; Ioannidou, Georgia; Zaramboukas, Thomas; Emmanouilides, Christos; Baka, Sofia; Kosmidou, Maria; Basdanis, G.; Fachantidis, Epaminondas

doi:10.1186/1757-1626-1-49

Cited by 9 publications

(7 citation statements)

References 11 publications

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“…As the patient had a history of colon cancer, we first presumed that the BM and AM originated from the colon. However, BM and AM from colon cancer are relatively rare, and the staining pattern of previous colon cancer was inconsistent with that of the adrenal tumor [9][10][11]. Thus, we concluded that the metastasis was not from the colon.…”

Section: Discussionmentioning

confidence: 77%

Brain and Adrenal Metastasis From Unknown Primary Tumor: A Case Report

Katsumata¹,

Monobe²,

Akagi³

et al. 2022

Cureus

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The clinical management of brain metastasis (BM) and adrenal metastasis (AM) of cancer of unknown primary (CUP) can be challenging. A 73-year-old man presented to the hospital with sudden-onset hemiplegia. His laboratory data were normal, except for elevated levels of carcinoembryonic antigen (CEA) (33.8 ng/mL). Contrast-enhanced magnetic resonance imaging revealed a 2-cm mass with ring enhancement in the right parietal lobe and extensive vasogenic edema around the tumor. The lesion was diagnosed as BM; however, we could not detect the primary origin by fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET-CT). Stereotactic radiotherapy was then administered, resulting in reduced tumor size and relief of symptoms. Follow-up after one year revealed an elevated CEA level (148.6 ng/mL) and remarkable fluorodeoxyglucose (FDG) uptake in the right adrenal gland, with an area of enhancement of 20 mm, on FDG-positron emission tomography computed tomography, with normal findings in other distant organs. He underwent adrenalectomy, and the adrenal tumor was diagnosed as a poorly differentiated adenocarcinoma likely of lung origin based on the histopathologic and immunohistochemistry findings of cytokeratin (CK) 7 (+), CK 20 (-), thyroid transcription factor-1 (TTF-1) (+), inhibin (-), napsin A (+), prostate-specific antigen (PSA) (-), caudal type homeobox 2 (CDX-2) (-), synaptophysin (-), and p40 (-). Metastatic tumors of unknown primary origin remain latent. Aggressive treatment of these lesions can be beneficial for symptom relief, diagnosis, and prolongation of survival.

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Section: Discussionmentioning

confidence: 77%

Brain and Adrenal Metastasis From Unknown Primary Tumor: A Case Report

Katsumata¹,

Monobe²,

Akagi³

et al. 2022

Cureus

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“…By contrast, a solitary adrenal metastasis is extremely unusual. When a solitary adrenal metastasis is observed, surgical resection of the involved adrenal glands is associated with a good prognosis for patients ( 1 , 2 , 4 – 7 , 12 – 16 , 35 – 37 ). Muth et al reported that the factors associated with a longer survival time in patients with CRC, renal cell carcinoma, non-small-cell lung cancer and malignant melanoma were the tumor type, of which CRC demonstrated the best prognosis, no prior surgery or metastases, a long disease-free interval and potentially curative adrenalectomy at the time of surgery ( 32 ).…”

Section: Discussionmentioning

confidence: 99%

Long-term outcome of adrenalectomy for metastasis resulting from colorectal cancer with other metastatic sites: A report of 3 cases

Uemura

Kim²,

Ikeda

et al. 2016

Oncology Letters

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Metastasis to the adrenal glands is a relatively frequent observation at autopsy of patients that have succumbed to cancer. Long-term disease-free survival has been reported in patients following the resection of solitary adrenal metastasis resulting from colorectal cancer. In addition, following primary resection for colorectal cancer, solitary metastasis to the adrenal glands is rare, even in outpatients at routine follow-ups. Therefore, adrenal metastasis is usually detected in combination with multiple synchronous metastases at other sites in the terminal stages of cancer. Between 1998 and 2002, 3 patients with adrenal metastasis and other synchronous metastatic sites underwent surgery for adrenal metastasis at the Department of Gastroenterological Surgery at Osaka University. The other synchronous metastatic sites observed in the 3 patients consisted of lung and para-aortic lymph nodes. In total, 2 out of the 3 patients experienced long-term disease-free survival for >5 years following surgery and 1 patient underwent curative resection for recurrence of metastases in the liver and right adrenal gland 79 months subsequent to the initial resection for adrenal metastasis. All 3 patients survived for >90 months. In conclusion, aggressive surgical resection for adrenal metastasis and other metastatic sites resulting from colorectal cancer may result in a survival benefit in selected patients.

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“…Although the liver and the lung are the main metastatic sites of CRC, the adrenal metastasis is clinically rare. But in autopsy series, the metastasis ranges are from 1.9% to 17.4 [1,9]. The rate of detecting clinically silent adrenal masses has increased due to the widespread use of abdominal imaging modalities, including USG, PET-CT, MRI [10][11][12].…”

Section: Discussionmentioning

confidence: 99%

“…To identify the adrenal mass is either malign or benign biopsy should be performed. In autopsy studies, the prevalence of incidentaloma is 1-9% [13] and the rate of metastasis ranges from 1.9-17.4% [1,9]. It is generally accepted that a solitary adrenal metastasis should be resected immediately to achieve good prognosis in some cancer types [14][15].…”

Section: Discussionmentioning

confidence: 99%

Benign pheochromocytoma associated with colorectal cancer: Case report

Kaçan¹,

Kılıçkap²,

Babacan³

et al. 2013

CMJ

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Among all cancers, colorectal cancer is the second leading cause of cancer related death. Liver and lung are known as the main metastatic sites of colorectal cancer, on the other hand the metastasis of adrenal is clinically rare. Formerly, metastases were detected at autopsy, but due to improved imaging and diagnostic techniques, many of these lesions now can be detected on routine followup imaging. Patients with adrenal metastasis are considered having systemic spread and therefore unsuitable for surgical resection. That's why, isolated adrenal metastasis presents a therapeutic dilemma in colorectal cancer patients. In this case, we report an adrenal mass in a patient with colorectal cancer to whom rectosigmoidectomy, colectomy and adrenal metastasectomy were performed. The adrenal mass was benign. For solitary and resectable lesions adrenalectomy can be performed and prolonged survival can be achieved in selected patients. Also, this enables to achieve right histopathological diagnosis. Keywords: Colorectal cancer, adrenal mass, adrenalectomy ÖzetKolorektal kanser tüm kanserler arasında ölüme neden olan ikinci sıklıktaki kanserdir. Karaciğer ve akciğer kolorektal kanserlerin ana metastaz yerleri iken adrenal metastaz klinik olarak nadirdir. Eskiden metastazlar otopsilerde saptanırken, görüntüleme ve tanısal tekniklerin gelişmesi sayesinde rutin takiplerde fark edilebilir. Adrenal metastazı olan hastalar diffüz sistemik yayılım kabul edilir ve cerrahi rezeksiyona uygun değillerdir. Bu nedenle kolorektal kanserli hastalarda izole adrenal metastaz tedavide ikilem yaratmaktadır. Bu olguda hemikolektomi ve adrenal metastazektomi uygulanan kolorektal kanserli hastada adrenal kitleyi rapor etmekteyiz. Adrenal kitle iyi huylu idi. Rezeksiyona uygun klinik soliter lezyonlar seçili hastalarda yapılabilir ve uzun süreli sağkalım sağlar. Aynı zamanda doğru tanının konmasını sağlar. Anahtar sözcükler: Kolorektal kanser, adrenal kitle, adrenalektomiGeliş tarihi

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Adrenalectomy for solitary adrenal metastasis from colorectal cancer: A case report

Cited by 9 publications

References 11 publications

Brain and Adrenal Metastasis From Unknown Primary Tumor: A Case Report

Brain and Adrenal Metastasis From Unknown Primary Tumor: A Case Report

Long-term outcome of adrenalectomy for metastasis resulting from colorectal cancer with other metastatic sites: A report of 3 cases

Benign pheochromocytoma associated with colorectal cancer: Case report

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