Purpose
Metastasis to the adrenal glands is a relatively frequent finding at autopsy. Adrenal metastasis of colorectal carcinoma is rare (14 percent). Isolated adrenal metastasis is even rarer, and presents a therapeutic dilemma.
Methods
Between 1997 and 2006, eight patients (5 men; mean age, 62 years) underwent adrenalectomy for metastasis of colorectal carcinoma. The tumors were Stage D in four cases, Stage B in two cases, and Stage C in the remaining two. Adjuvant chemotherapy was instituted.
Results
All patients were asymptomatic, and adrenal metastasis was suspected from an elevated serum level of carcinoembryogenic antigen or discovered by computed tomography. Adrenal metastases were metachronous in seven patients, with median disease-free interval of 3.75 years. At the time of follow-up, one patient remained alive and free of disease 12 months after adrenalectomy, one patient was lost to follow-up after 22 months, and 6 patients have died from malignancy. The mean survival for the patients who died was 32 months.
Conclusions
The rarity of isolated adrenal metastasis of colorectal carcinoma makes a randomized, prospective trial comparing surgery vs. nonsurgical management highly unlikely. Our results provide further support for surgical resection of solitary adrenal metastasis, which may translate into survival benefit.
This is a preview of subscription content, log in via an institution to check access.
References
Cedermark BJ, Blumenson LE, Pickren JW, Holyoke DE. The significance of metastases to the adrenal glands in adenocarcinoma of the colon and rectum. Surg Gynecol Obstet 1977;144:537–46.
Adam R. Developing strategies for liver metastases from colorectal cancer. Semin Oncol 2007;34(2 Suppl 1):S7–11.
Pfannschmidt J, Dienemann H, Hoffmann H. Surgical resection of pulmonary metastases from colorectal cancer: a systematic review of published series. Ann Thorac Surg 2007;84:324–38.
Fujita K, Kameyama S, Kawamura M. Surgically removed adrenal metastasis from cancer of the rectum. Report of a case. Dis Colon Rectum 1988;31:141–3.
Kanjo T, Albertinin M, Weber S. Long-term disease-free survival after adrenalectomy for isolated colorectal metastases. Asian J Surg 2006;29:291–3.
Murakami S, Terakado M, Hashimoto T, Tsuji Y, Okubo K, Hirayama R. Adrenal metastasis from rectal cancer: report of a case. Surg Today 2003;33:126–30.
Katayama A, Mafune KI, Makuuchi M. Adrenalectomy for solitary adrenal metastasis from colorectal carcinoma. Jpn J Clin Oncol 2000;30:414–6.
Watatani M, Ooshima M, Wada T, et al. Adrenal metastasis from carcinoma of the colon and rectum: a report of three cases. Surg Today 1993;23:444–8.
Kim SH, Brennan MF, Russo P, Burt ME, Colt DG. The role of surgery in the treatment of clinically isolated adrenal metastasis. Cancer 1998;82:389–94.
Adam R, Miller R, Pitombo M, et al. Two-stage hepatectomy approach for initially unresectable colorectal hepatic metastases. Surg Oncol Clin N Am 2007;16:525–36.
Nagakura S, Shiari Y, Nomura T, Hatakeyama K. Long-term survival after resection of colonic adenocarcinoma with synchronous metastases to the liver, adrenal gland, and aortico-caval lymph nodes. Report of a case. Dis Colon Rectum 2002;45:1679–80.
Lo CY, van Heerden JA, Soreide CS, et al. Adrenalectomy for metastatic disease to the adrenal glands. Br J Surg 1996;83:528–31.
Candel AG, Gattuso P, Reyes C, Prinz RA, Castelli MJ. Fine-needle aspiration biopsy of adrenal masses in patients with extraadrenal malignancy. Surgery 1993;114:1132–7.
Author information
Authors and Affiliations
Corresponding author
Additional information
Reprints are not available.
About this article
Cite this article
Mourra, N., Hoeffel, C., Duvillard, P. et al. Adrenalectomy for Clinically Isolated Metastasis from Colorectal Carcinoma: Report of Eight Cases. Dis Colon Rectum 51, 1846–1849 (2008). https://doi.org/10.1007/s10350-008-9235-2
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10350-008-9235-2