Factors Influencing Adrenal Metastasis in Renal Cell Carcinoma

Abstract

The factors predisposing to adrenal metastasis in renal cell carcinoma were reviewed in 695 cases. The overall incidence of adrenal metastasis was 4.3%. The risk of adrenal metastasis correlated with tumors that were on the left side, large and replacing the entire kidney, upper pole in location and of advanced T stage. Nevertheless, microscopic and/or contralateral adrenal metastasis was noted in patients with smaller, lower pole or mid renal tumors. Of 30 patients with adrenal metastasis 9 (30%) had clinical evidence of widespread disease. Among the patients who underwent complete surgical resection 14% had either positive lymph nodes or other non-adrenal metastases. Of the patients undergoing resection 81% died, with a mean postoperative survival of 27 months. Sustained disease-free survival was noted in 3 patients (0.43% of the entire series) whose complete pathological staging was pT1-3b, N0, M0. The need and benefit of adrenalectomy during surgery for renal cell carcinoma are extremely limited.

Synchronous renal cell carcinoma metastasis to the contralateral adrenal gland and pancreas: A case report with 7-year follow-up subsequent to surgical therapy

“…Notably, previous studies have demonstrated that contralateral adrenal metastases are able to grow to a considerable size, even when originating from only a small number of metastatic RCC cells, and without metastasizing to other organs; therefore, the adrenal gland may have an increased affinity for RCC spread compared with other organs (9,10).…”

The Current Radiological Approach to Renal Cell Carcinoma

“…Perinefritik boşlukta kontrastlanan nodülün mevcudiyeti oldukça spesifik bir bulgu olmakla birlikte sensitivitesi sadece %46 olarak belirtilmiştir (20). İpsilateral adrenal bez tutulumu %4,3 oranında tanımlanmıştır (21). BT incelemesinde normal olarak tanımlanan bir çalışmada negatif öngörü değeri %100 olarak bulunmuştur.…”

Tratamiento quirúrgico de las metástasis del cáncer renal

“…En las piezas de nefrectomía radical la glándula ipsilateral se encuentra afectada en el 4,3% de los casos. Como factores predisponentes se consideran: tumores grandes, de estadio avanzado, localizados en polo superior e izquierdos 49 .…”

“…Siempre irá acompañada de linfadenectomía retroperitoneal ampliada, por la elevada correlación entre metásta-sis adrenales y adenopatías positivas (30%) 49 . Si la metástasis es bilateral, circunstancia extremadamente rara, las posibilidades de tratamiento son más complicadas.…”