Metastatic Renal Cell Carcinoma and Unforeseen Adrenal Insufficiency: A Case Report and Literature Review

Abstract

Renal cell carcinoma (RCC) can metastasize to nearly every organ, yet rarely metastasizes to the adrenal glands despite their anatomical proximity. Adrenal metastases are typically incidental findings on medical imaging and are vastly clinically asymptomatic. The adrenal glands can maintain hormonal homeostasis if a tenth of total adrenal gland function is preserved. We present a patient with synchronous bilateral adrenal metastases from RCC with rapid and unexpected development of adrenal insufficiency (AI).

Diagnosis and Treatment of Adrenal Metastasis in Modern Era

“…Uniquely, the standard approach in treating adrenal malignancies with origins from renal cancers is selective inclusion of ipsilateral adrenalectomy with radical nephrectomy rather than routine or considered adrenalectomy [27]. However, adrenal malignancies from renal cancers are often as a result of local invasion of renal cancer cells to the ipsilateral adrenal gland rather than traditional metastasis of the renal cancer [28].…”