Metastatic carcinomas of the adrenal glands: From diagnosis to treatment

Abstract

Background/Aim: Adrenal glands are one of the most common sites of cancer metastasis. The treatment options include either surgery or chemotherapy and/or radiotherapy while certain diagnosis is made via percutaneous biopsy or fine needle aspiration (FNA), guided by CT scan. This review aimed to present the current practice regarding the diagnosis and treatment of adrenal cancer metastasis. Materials and Methods: A PRISMA-compliant systematic search of the PubMed, Cochrane, EMBASE, AMED, CINAHL, WoS, BIOSIS, LILACS, ASSIA, SCEH, SCIRUS databases, and JIT medical feed sources was performed through November 5th, 2018. Results: A total of 87 original studies including 660 patients with adrenal metastasis were analyzed. Most preferred treatment was excision of the gland in 76.58% of the cases, while most of adrenal metastases were found at autopsy (43.88%) followed by computed tomography guided biopsy (33.09%). Conclusion: Adrenalectomy following metastatic disease to the adrenals should be performed when the lesion is isolated in the gland and the site of primary cancer has or can be resected.