Solitary contralateral adrenal metastasis of renal cell carcinoma 15 years following radical nephrectomy: A case report and review of literature

Abstract

Highlights A well-recognized phenomenon in RCC is late metastatic recurrence after nephrectomy. Solitary contralateral adrenal metastatic recurrence of RCC is extremely rare. Early diagnosis of adrenal metastasis is challenging because they are usually silent. This paper is the delayed solitary metastatic recurrence of the renal cell carcinoma to the contralateral adrenal gland.

Differential VHL Mutation Patterns in Bilateral Clear Cell RCC Distinguishes Between Independent Primary Tumors and Contralateral Metastatic Disease

“…[12][13][14] A few case reports show evidence of metastatic spread from 1 kidney to the contralateral kidney, adrenal or kidney region. [21][22][23] In the current study, all patients developed tumors in both kidneys. Metachronous disease was more common (4/5; 80%) in the group that demonstrated contralateral metastases than in those in which tumors grew independently (3/14; 21%), but both synchronous and metachronous contralateral disease was observed in both cohorts.…”

Bilateral adrenal metastasis of renal cell carcinoma 4 years after radical nephrectomy

“…In most previously published cases, adrenal metastases occurred simultaneously with RCC, therefore the available information on metachronous metastasis is incomplete and relevant therapeutics experience is limited. Nevertheless, with the advance of surgical technology, adrenalectomy with the aim of prolonging survival has been regarded as the standard of care in patients with adrenal metastasis [7] . Laparoscopic adrenalectomy has advantages such as rapid recovery, less pain, better cosmetic results, lower percentage of incision hernia, and rapid return to possible systemic therapy for metastatic diseases [8] .…”

Metachronous Renal Cell Carcinoma: A Rare Presentation of Adrenal Crisis

“…Metastatic spread can occur in almost any organ system, with the lungs, abdomen, bones, and brain the most commonly involved sites. Although juxtaposed to the kidney, the adrenal gland is uncommonly involved with metastasis to ipsilateral and contralateral adrenal, being around 3% and 0.7%, respectively [ 2 ]. We discuss the case of a 59-year-old male who presented to our tertiary care setup with atypical chest pain and altered mental status, who subsequently developed hypotension and hyponatremia, raising concern for adrenal insufficiency (AI).…”