Metastases of Renal Cell Carcinoma to the Contralateral Adrenal Gland Managed by Laparoscopic Adrenalectomy

We report our experience with laparoscopic management of contralateral, metachronous adrenal metastases from RCC. Patients undergoing radical/partial nephrectomy for RCC were prospectively followed and evaluated regularly for general health status, local recurrence of tumor, and distant metastases. Patients identified to have had adrenal lesion/mass during the follow-up period were evaluated in detail both with imaging as well as endocrinal evaluation for assessment of functional status of these lesions. All these patients underwent laparoscopic adrenalectomy under general anesthesia. During the study period Jan 2006 –Dec 2015, 8 patients (7 male and 1 female) with a mean age of 57.8 years underwent laparoscopic adrenalectomy. The mean operating time was 111.2 ± 32.5 min, blood loss was 45 ± 8.6 cm3 and postoperative stay was 37.5  ± 9.3 h. None of the patients had any major complications both early and delayed. The overall survival was 44.62 months. Metachronous, solitary, and contralateral adrenal metastasis from RCC is an extremely rare clinical complication that can occur very late after the radical/partial nephrecto my. Increased use of imaging modalities has led to more efficient and early detection of these lesions. Aggressive surgery remains the treatment of choice in these cases. Laparoscopic adrenalectomy remains a good, safe option with minimal morbidity and short hospital stay.
Source: Indian Journal of Surgical Oncology - Category: Cancer & Oncology Source Type: research