CONTRALATERAL ADRENAL METASTASIS IN RENAL CELL CARCINOMA
Approximately one third of patients discovered to have renal cell carcinoma already have distant metastasis at the time of tumor diagnosis. The commonest sites for metastasis are lungs, lymphnodes, and bones. Adrenal metastasis is a fairly common finding in autopsy series with a 7 to 19 per cent inc...
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Published in | Nippon Hinyokika Gakkai zasshi Vol. 75; no. 10; pp. 1646 - 1651 |
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Main Authors | , , , |
Format | Journal Article |
Language | Japanese |
Published |
Japan
THE JAPANESE UROLOGICAL ASSOCIATION
01.10.1984
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Abstract | Approximately one third of patients discovered to have renal cell carcinoma already have distant metastasis at the time of tumor diagnosis. The commonest sites for metastasis are lungs, lymphnodes, and bones. Adrenal metastasis is a fairly common finding in autopsy series with a 7 to 19 per cent incidence reported. Nonetheless, the diagnosis of the metastasis to the adrenal is uncommon during life. In the literature, ipsilateral adrenal involvement has been previously reported to occur in 5.7% of all patients undergoing radical nephrectomy for renal cell carcinoma. In contrast, it seems suprising that metastatic renal cell carcinoma in the contralateral adrenal gland is not found more frequently. A case of a contralateral adrenal metastasis is here presented, and the literature is reviewed. A 77-year-old man was admitted to a local hospital on October 1977, with urinary retention and gross hematuria. The patient was referred to our department, where extensive roentogenographic studies were performed. Results of arteriography and vena cavography demonstrated a large hypervascular mass in the upper pole of the kidney and tumor thrombus in the renal vein and vena cava consistent with a renal cell carcinoma. The patient underwent transcather embolization because of massive bleeding, thereafter a right radical nephrectomy an adrenalectomy including inferior vena cava wall resection. One year after discharge a CT scan disclosed a left suprarenal mass in the contralateral adrenal, suggestive of metastatic renal cell carcinoma. A left adrenalectomy was performed for treatment of the solitary metastatic lesion. Histologically, the tumor of the left adrenal was identical to the right renal cell carcinoma. The patient required adrenal cortical steroid (Hydrocortisone) and remained well over a two year follow-up interval. |
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AbstractList | Approximately one third of patients discovered to have renal cell carcinoma already have distant metastasis at the time of tumor diagnosis. The commonest sites for metastasis are lungs, lymphnodes, and bones. Adrenal metastasis is a fairly common finding in autopsy series with a 7 to 19 per cent incidence reported. Nonetheless, the diagnosis of the metastasis to the adrenal is uncommon during life. In the literature, ipsilateral adrenal involvement has been previously reported to occur in 5.7% of all patients undergoing radical nephrectomy for renal cell carcinoma. In contrast, it seems suprising that metastatic renal cell carcinoma in the contralateral adrenal gland is not found more frequently. A case of a contralateral adrenal metastasis is here presented, and the literature is reviewed. A 77-year-old man was admitted to a local hospital on October 1977, with urinary retention and gross hematuria. The patient was referred to our department, where extensive roentogenographic studies were performed. Results of arteriography and vena cavography demonstrated a large hypervascular mass in the upper pole of the kidney and tumor thrombus in the renal vein and vena cava consistent with a renal cell carcinoma. The patient underwent transcather embolization because of massive bleeding, thereafter a right radical nephrectomy an adrenalectomy including inferior vena cava wall resection. One year after discharge a CT scan disclosed a left suprarenal mass in the contralateral adrenal, suggestive of metastatic renal cell carcinoma. A left adrenalectomy was performed for treatment of the solitary metastatic lesion. Histologically, the tumor of the left adrenal was identical to the right renal cell carcinoma. The patient required adrenal cortical steroid (Hydrocortisone) and remained well over a two year follow-up interval. |
Author | Kawashima, Toshifumi Shiramizu, Miki Katsuoka, Yoji Murakami, Yasuhide |
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References | 9) Foucar, E. and Dehner, L. P.: Renal cell carcinoma occurring with contralateral adrenalmetastasis. Arch. Surg., 114, 959-963, 1979. 2) Wright, F. W.: Adrenal metstasees from renal carcinoma diagnosed by selective renal angiography. Br. J. Urol., 46, 472, 1974. 16) Lang, E. K.: Angeriographic assessment and staging of renal cell carcinoma. Radiology, 101, 17-27, 1971. 14) 三方律治, 木下健二: 孤立性対側副腎転移を来した腎細胞癌の1例. 臨床泌尿器科, 38, 57-59, 1984. 18) Willis, R. A.: Secondary tumours of the adrenals. In the spread of tumours in the human body, 3rd, ed., p. 198, Butterworths & Co, Ltd., London, 1973. 17) Saitoh, H.: Distant metastasis of renal adenocarcinoma in patients with a tumor thrombus in the renal vein and/or vena cava. J. Urol., 127, 652-653, 1982. 10) 期波光生, 南茂正, 高村孝夫: 対側副腎に巨大な転移を示めした腎腫瘍. 臨床泌尿器科, 26, 369-370, 1972. 1) Hajdn, S. I. and Thomas, A. G.: Renal cell carcinoma at autopsy. J. Urol., 97, 978-982, 1967. 4) Robson, C. J., Churchill, B. M. and Anderson, W.: The results of radical nephrectomy for renal cell carcinoma. J. Urol., 101, 297-301, 1969. 6) Lucke, B. and Schlumberger, H. G.: Tumors of the kidney, renal pelvis and ureter, in Atlas of tumor pathology, p. 43, A. E. I. P., Washington, D. C., 1957. 15) Saitoh, N., Shiramizu, T. and Hida, M.: Age changes in metastatic patients in renal adenocarcinoma. Cancer, 50 (8), 1646 0 1648, 1982. 11) 久住治男, 高野学: 両側副腎に比較的大きい転移性腫瘍を伴った腎癌症例. 臨床泌尿器科, 34, 1105-1109, 1980. 7) Bennington, J. L. and Beckwith, J. B.: Distribution of metastases from renal adenocarcinoma. In tumors of the kidney, renal pelvis, and ureter. p. 168, A. F. I. P., Washington, D. C., 1975. 3) Campbell, C. M., Middleton, and Rigby, O. F.: Adrenal metastasis in renal cell carcinoma. Urology., 21 (4), 403-405, 1983. 13) 増田富士男, 大西哲郎, 東陽一郎, 池本康, 町田豊平: 腎細胞癌の対側副腎転移. 日本泌尿器科学会誌, 74, 2138-2141, 1983. 8) Saitoh, H.: Distant metastasis of renal adenocarcinoma. Cancer 48 (6), 1487-1491, 1981. 5) Middleton, R. G.: Surgery for metastatic renal cell carcinoma. J. Urol., 97, 973-977, 1967. 12) 峰山浩忠, 小松原秀一, 阿部札男: 両側副腎に転移を示した腎細胞癌の1手術例. 西日本泌尿器科, 43, 997-1001, 1981. |
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SubjectTerms | Adrenal Gland Neoplasms - diagnostic imaging Adrenal Gland Neoplasms - secondary Aged Carcinoma, Renal Cell - secondary Humans Kidney Neoplasms - pathology Kidney Neoplasms - therapy Male Tomography, X-Ray Computed |
Title | CONTRALATERAL ADRENAL METASTASIS IN RENAL CELL CARCINOMA |
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