Adrenalectomy For Isolated Metastasis In Five Patients With Lung Cancer: Single Centre Experience and Review of the Literature

Abstract

Isolated adrenal metastasis from non-small cell lung cancer (NSCLC) is arare event. Nonsurgical treatment of a solitary adrenal metastasis isassociated with poor survival. However, in the aspect of long-termsurvival, the role of adrenalectomy for isolated metastasis is unclear.Here, we reported our experience with surgical treatment of solitaryadrenal metastasis in patients with NSCLC whose primary tumor controlwere achieved and reviewed current literature. Between the 2001 and2009, five patients underwent curative adrenalectomy (in 1 patient itwas bilateral) for suspected solitary adrenal metastasis after surgicaltreatment of NSCLC. The pathologic examination confirmed in 3 cases aNSCLC metastasis while in 2 cases it was a benign lesion. In thefollow-up period, all of the 3 patients with adrenal metastasis hadrecurrence of NSCLC. Recurrence was local (in the operated adrenal bed)in 2 patients. Palliative radiotherapy focalized to adrenal bed wasgiven to one of the patient with local recurrence. This patient iscurrently alive 51 months after the adrenalectomy. The other patientwith local recurrence died 24 months after the adrenalectomy. Recurrencewas systemic (brain and contralateral adrenal gland) in 1 patient whowas treated with contralateral adrenalectomy and surgical resection ofthe cranial metastasis followed by cranial radiotherapy. The patient whounderwent bilateral adrenalectomy for metastatic lung cancer died ofwide-spread metastatic disease, 79 months after the adrenalectomy. Inconclusion, survival benefit can be obtained after complete resection ofisolated adrenal metastasis in patients with NSCLC. Therefore, resectionof isolated adrenal metastasis should be considered if the primary NSCLCis resectable.