Long-term Survival after Surgical Treatment of Metachronous Bilateral Adrenal Metastases of Non-small Cell Lung Carcinoma
Unusual clinical course, Unusual or unexpected effect of treatment, Educational Purpose (only if useful for a systematic review or synthesis)
Naohiro Taira, Tsutomu Kawabata, Takaharu Ichi, Kazuaki Kushi, Tomofumi Yohena, Hidenori Kawasaki, Kiyoshi Ishikawa
Department of General Surgery, National Hospital Organization, Okinawa National Hospital, Ginowan, Japan
Am J Case Rep 2014; 15:444-446
Although resection of the metastases is the treatment of choice for unilateral solitary adrenal metastasis of non-small cell lung carcinoma (NSCLC), the surgical treatment for bilateral adrenal metastases is quite rare, likely due to the coexistence of multiple synchronous metastases at other sites and/or primary adrenal insufficiency following bilateral adrenalectomy. We herein report a rare case of asynchronous metastasis of NSCLC to the bilateral adrenal glands with long-term survival after bilateral adrenalectomy.
Case Report: A 70-year-old male underwent right upper lobectomy for lung adenocarcinomaT2aN2M0, stageIIIA following induction chemotherapy. Forty-four months later, right adrenalectomy of a right adrenal tumor was performed, which revealed metastatic lung carcinoma.
Following the administration of adjuvant chemotherapy, a metastatic tumor was detected in the left adrenal gland. Although there were no other signs of distant metastasis on radiological examinations, he underwent the chemotherapy due to the risk of adrenal insufficiency. However, on follow-up CT the adrenal lesion was found to have enlarged; therefore, left adrenalectomy was performed. Three years and six months later, he was doing well, with no evidence of recurrence.
Conclusions: Selected patients with solitary adrenal metastases of NSCLC can benefit from an aggressive treatment approach, even if such metastases are bilateral.
Keywords: Adrenal Gland Neoplasms - surgery, Adrenalectomy - methods, Aged, Carcinoma, Non-Small-Cell Lung - surgery, Follow-Up Studies, Humans, Lung Neoplasms - surgery, Male, Neoplasms, Second Primary, Positron-Emission Tomography, Prognosis, Time Factors, Tomography, X-Ray Computed