Metachronous adrenal masses in resected non-small cell lung cancer patients: therapeutic implications of laparoscopic adrenalectomy

Lucchi, Marco; Dini, Paolo; Carlo Ambrogi, Marcello; Berti, Piero; Materazzi, Gabriele; Miccoli, Paolo; Mussi, Alfredo
May 2005
European Journal of Cardio-Thoracic Surgery;May2005, Vol. 27 Issue 5, p753
Academic Journal
Abstract: Objective: In literature only few reports focused on the resection of solitary adrenal gland metastasis in patients operated on for non-small cell lung cancer (NSCLC). We report our experience on laparoscopic adrenalectomy for suspected or confirmed metachronous solitary adrenal metastasis from NSCLC and discuss its therapeutic role. Methods: From June 1993 to March 2003, 14 patients (pts), who had been undergone lung resection for NSCLC, with suspected or confirmed solitary adrenal gland metastasis at the follow-up, underwent 15 laparoscopic adrenalectomy (in 1 patient it was bilateral). All the patients had enlarged adrenal glands at the abdominal ultrasound or CT. All but 2 pts underwent at least 1 adrenal fine needle aspiration. All the patients underwent a careful staging to exclude other sites of metastasis. The adrenal gland was in 6 cases the right, in 9 cases the left. Results: In 7 cases we had a preoperative cytological diagnosis of metastasis. In 1 case adrenalectomy was not performed because of infiltration of vena cava and in 1 case it was necessary to perform a small laparotomy because of bleeding. The pathologic examination confirmed in 11 cases a NSCLC metastasis while in 4 cases it was a cortical adenoma. Regarding the 10 patients with NSCLC metastases, 3 are still alive and well at 37–80 months from the lung resection. One patient (who underwent bilateral adrenalectomy) is still alive at 44 months with local relapse. Two patients died 5 and 6 months after the adrenalectomy for other causes, 1 died at 14 months for local and systemic relapse and the remaining 3 patients died at 12 to 38 months for systemic relapse. Conclusions: Laparoscopic adrenalectomy in patients resected for NSCLC is a safe mini-invasive procedure. Even though this series is still too small, laparoscopic adrenalectomy should be considered an effective therapeutic tool in case of progressive adrenal gland enlargement, also with negative cytological examinations. A bigger series and other institution experiences will clarify its oncological value.


Related Articles

  • An all or none phenomenon? Loughlin, Kevin R. // Contemporary Urology;Aug2002, Vol. 14 Issue 8, p50 

    Focuses on a debate over whether adrenalectomy should routinely be part of a radical nephrectomy procedure. Rationale for removing the adrenal gland during radical nephrectomy; Surgical alternatives to radical nephrectomy; Survival rate of patients with adrenal metastases.

  • Retroperitoneal Paraganglioma: Single-Institution Experience and Review of the Literature Cunningham, Steven C.; Suh, Hyun S.; Winter, Jordan M.; Montgomery, Elizabeth; Schulick, Richard D.; Cameron, John L.; Yeo, Charles J. // Journal of Gastrointestinal Surgery;Sep2006, Vol. 10 Issue 8, p1156 

    Paragangliomas are rare tumors arising from extra-adrenal chromaffin cells. We examined the clinical characteristics of all patients at our institution having paragangliomas resected from 1984 through 2005. Of 253 resections, 22 (9%) were retroperitoneal and were selected for further study. The...

  • Malignant pheochromocytoma: new malignancy criteria. Wailly, Pierre; Oragano, Luigi; Radé, Francois; Beaulieu, Anthony; Arnault, Vincent; Levillain, Pierre; Kraimps, Jean // Langenbeck's Archives of Surgery;Feb2012, Vol. 397 Issue 2, p239 

    Purpose: The pathological diagnosis of malignancy in pheochromocytomas remains a controversial issue. According to the WHO, malignancy is defined in the presence of metastasis. Multiparameter scoring systems such as PASS (Pheochromocytoma of Adrenal gland Scaled Score) have been used but remain...

  • SELF ASSESSMENT ANSWERS: Adrenal mass in a diabetic with hypergastrinaemia.  // Postgraduate Medical Journal;Oct2001, Vol. 77 Issue 912, p671 

    This article presents several questions and answers related to adrenal mass in a diabetic with hypergastrinaemia. There are various clinical manifestations of hypercalcaemia. Adrenal tumours are common in MEN1 syndrome and have been reported in up to 36% of these patients. They are usually...

  • Chest wall metastasis from hepatocellular carcinoma in the absence of a primary: An unusual presentation. Talapatra, Kaustav; Engineer, Reena; Agarwal, Jai Prakash; Vyas, Shilpa; Shrivastava, Shyam Kishore // Journal of Cancer Research & Therapeutics;Jan2008, Vol. 4 Issue 1, p42 

    Metastatic hepatocellular carcinoma (HCC) has an aggressive course with a very poor outcome. The common hematogenous metastatic sites are the lungs, bones, and adrenal glands. The chest wall is an extremely rare site of metastasis from HCC. We report a rare presentation in a gentleman, where the...

  • Twenty-six-years’ survival with multiple bone metastasis of malignant pheochromocytoma. Yoshida, Shuichi; Hatori, Masahito; Noshiro, Takao; Kimura, Noriko; Kokubun, Shoichi // Archives of Orthopaedic & Trauma Surgery;Oct2001, Vol. 121 Issue 10, p598 

    The prognosis of metastatic pheochromocytoma is poor in general. There have been few instances of long-term survival reported. We report a case of a 44-year-old woman who has survived for 26 years after bone metastasis. She was diagnosed as having pheochromocytoma arising in the left adrenal...

  • Long-Term Survival after Adrenalectomy for Asynchronous Metastasis of Bladder Cancer to the Bilateral Adrenal Glands. Washino, S.; Hirai, M.; Matsuzaki, A.; Kobayashi, Y. // Case Reports in Urology;2012, p1 

    Isolated adrenal metastasis of bladder cancer, particularly the bilateral, is quite rare. Systemic chemotherapy is the treatment of choice for metastatic urothelial carcinoma. However, despite initially promising response rates of approximately 45%-71%, most tumors eventually show progression,...

  • Prognostic significance of adrenal gland morphology at CT in patients with three common malignancies. Meehan, C. P.; Fuqua Iii, J. L.; Reiner, A. S.; Moskowitz, C. S.; Schwartz, L. H.; Panicek, D. M. // British Journal of Radiology;Jun2012, Vol. 85 Issue 1014, p807 

    Objectives: To determine whether minor alterations in adrenal gland morphology at baseline CT in three common cancers indicate early metastasis. Methods: 689 patients (237 with lung cancer, 228 with breast cancer, 224 with melanoma) underwent baseline and follow-up CTs that included the...

  • Surgical management of adrenal metastases. Sancho, Juan; Triponez, Frédéric; Montet, Xavier; Sitges-Serra, Antonio // Langenbeck's Archives of Surgery;Feb2012, Vol. 397 Issue 2, p179 

    Purpose: This paper aims to review controversies in the management of adrenal gland metastasis and to reach an evidence-based consensus. Materials and methods: A review of English-language studies addressing the management of adrenal metastasis, including indications for surgery, diagnostic...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics