Adrenal metastases: clinical manifestations and surgical outcomes

Background. The adrenal glands are one of the most common sites of metastases in malignant disease, particularly lung cancer. The frequency of adrenal metastasis in patients with breast cancer and lung cancer reaches 39 and 35 % respectively.Materials and methods. A total of 156 patients with adrenal tumors underwent surgical treatment in the Siberian State Medical University between December 1998 and July 2017. The study included 16 (10.2 %) patients (9 males and 7 females) with adrenal metastases. The mean age of study participants was 57.6 years (range: 44–73 years).Results. By the moment of surgery, the mean metastatic adrenal tumor size was 4.9 ± 3.0 cm (range: 1.0–10.2 cm). Thirteen out of 16 patients had adrenal metastases from renal cell carcinoma, one patient – from colon cancer, one patient – from lung cancer, and one patient – from breast cancer. Nine patients had left-sided adrenal metastases, whereas six patients had right-sided adrenal metastases. Synchronous adrenal metastasis was detected in two cases: one patient had adrenal metastasis at the side of the renal tumor; the other one had bilateral renal cell carcinoma with both adrenal glands affected.We identified three main variants of the disease course according to prevailing clinical manifestations of adrenal metastasis: no manifestations, pain syndrome, and arterial hypertension.Seven participants had no clinical manifestations; of them, 6 patients had renal cell carcinoma, whereas 1 patient had breast cancer. The mean time between surgical removal of the primary tumor and detection of adrenal metastases was 24.1 months; the mean tumor size was 4.5 cm.Pain syndrome was observed in 5 patients. In three of them, adrenal metastases derived from renal cell carcinoma, in one patient – from lung cancer, and in one patient – from colon cancer. The mean time between removal of the primary tumor and detection of adrenal metastases was 19.8 months; the mean tumor size was 5.4 cm.Arterial hypertension was diagnosed in four patients. The mean time between removal of the primary tumor and identification of adrenal metastases was 27.3 months; the mean tumor size was 4.1 cm. The five-year overall survival rate in operated patient was 47.8 %.Conclusion. Regular examinations of patients after surgical treatment of malignant tumors are needed to detect adrenal metastases; surgery can extend the patient’s life. can extend the patient’s life.

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FDG PET/CT in the Evaluation of Late Manifestation of Adrenal Metastasis after Radical Nephrectomy in Patients with Renal Cell Carcinoma: A Report of Four Cases and Review of Literature

International Journal of Nuclear Medicine Research ◽

10.15379/2408-9788.2014.01.01.5 ◽

2014 ◽

Vol 1 (1) ◽

pp. 24-27

Author(s):

Koramadai Kamaleshwaran ◽

◽

Anish Bhattacharya ◽

Arup Mandal ◽

Shravan Singh ◽

...

Keyword(s):

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Fdg Pet ◽

Renal Cell ◽

Radical Nephrectomy ◽

Adrenal Metastasis ◽

Review Of Literature ◽

Pet Ct ◽

Fdg Pet Ct ◽

Late Manifestation

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Quantitative 3-tesla multiparametric MRI in differentiation between renal cell carcinoma subtypes

Egyptian Journal of Radiology and Nuclear Medicine ◽

10.1186/s43055-020-00405-w ◽

2021 ◽

Vol 52 (1) ◽

Author(s):

Ali Elsorougy ◽

Hashim Farg ◽

Dalia Bayoumi ◽

Mohamed Abou El-Ghar ◽

Magda Shady

Keyword(s):

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Renal Cell ◽

Clear Cell ◽

Multiparametric Mri ◽

Histopathological Analysis ◽

Adc Value ◽

Intensity Index ◽

Apparent Diffusion ◽

The Mean

Abstract Background MRI provides several distinct quantitative parameters that may better differentiate renal cell carcinoma (RCC) subtypes. The purpose of the study is to evaluate the diagnostic accuracy of apparent diffusion coefficient (ADC), chemical shift signal intensity index (SII), and contrast enhancement in differentiation between different subtypes of renal cell carcinoma. Results There were 63 RCC as regard surgical histopathological analysis: 43 clear cell (ccRCC), 12 papillary (pRCC), and 8 chromophobe (cbRCC). The mean ADC ratio for ccRCC (0.75 ± 0.13) was significantly higher than that of pRCC (0.46 ± 0.12, P < 0.001) and cbRCC (0.41 ± 0.15, P < 0.001). The mean ADC value for ccRCC (1.56 ± 0.27 × 10−3 mm2/s) was significantly higher than that of pRCC (0.96 ± 0.25 × 10−3 mm2/s, P < 0.001) and cbRCC (0.89 ± 0.29 × 10−3 mm2/s, P < 0.001). The mean SII of pRCC (1.49 ± 0.04) was significantly higher than that of ccRCC (0.93 ± 0.01, P < 0.001) and cbRCC (1.01 ± 0.16, P < 0.001). The ccRCC absolute corticomedullary enhancement (196.7 ± 81.6) was significantly greater than that of cbRCC (177.8 ± 77.7, P < 0.001) and pRCC (164.3 ± 84.6, P < 0.001). Conclusion Our study demonstrated that multiparametric MRI is able to afford some quantitative features such as ADC ratio, SII, and absolute corticomedullary enhancement which can be used to accurately distinguish different subtypes of renal cell carcinoma.

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Factors Influencing Adrenal Metastasis in Renal Cell Carcinoma

The Journal of Urology ◽

10.1016/s0022-5347(17)35208-4 ◽

1994 ◽

Vol 151 (5) ◽

pp. 1181-1184 ◽

Cited By ~ 87

Author(s):

Arthur I. Sagalowsky ◽

Keith T. Kadesky ◽

David M. Ewalt ◽

Tim J. Kennedy

Keyword(s):

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Renal Cell ◽

Adrenal Metastasis ◽

Factors Influencing

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Comparison of General Anesthesia and Conscious Sedation during Computed Tomography–Guided Radiofrequency Ablation of T1a Renal Cell Carcinoma

Canadian Association of Radiologists Journal ◽

10.1016/j.carj.2017.07.003 ◽

2018 ◽

Vol 69 (1) ◽

pp. 24-29 ◽

Cited By ~ 8

Author(s):

Hae Jin Kim ◽

Byung Kwan Park ◽

In Sun Chung

Keyword(s):

Renal Cell Carcinoma ◽

Radiofrequency Ablation ◽

General Anesthesia ◽

Cell Carcinoma ◽

Renal Cell ◽

Conscious Sedation ◽

Tumour Progression ◽

Tumour Size ◽

General Anesthesia Group ◽

The Mean

Purpose Percutaneous radiofrequency ablation is so painful that this treatment requires pain control such as conscious sedation or general anesthesia. It is still unclear which type of anesthesia is better for treatment outcomes of renal cell carcinoma. This study aimed to compare general anesthesia and conscious sedation in treating patients with renal cell carcinoma with radiofrequency ablation. Methods Between 2010 and 2015, 51 patients with biopsy-proven renal cell carcinomas (<4 cm) were treated with computed tomography–guided radiofrequency ablation. General anesthesia was performed in 41 and conscious sedation was performed in 10 patients. Tumour size, local tumour progression, metastasis, major complication, effective dose, glomerular filtration rate difference, and recurrence-free survival rate were compared between these groups. Results The mean tumour size was 2.1 cm in both groups ( P = .673). Local tumour progression occurred in 0% (0 of 41) of the general anesthesia group, but in 40% (4 of 10) of the conscious sedation group ( P = .001). Metastases in these groups occurred in 2.4% (1 of 41) of the general anesthesia group and 20% (2 of 10) of the conscious sedation group ( P = .094). No major complications developed in either group after the first radiofrequency ablation session. The mean effective doses in these groups were 21.7 mSv and 21.2 mSv, respectively ( P = .868). The mean glomerular filtration rate differences in the general anesthesia and conscious sedation groups were −13.5 mL/min/1.73 m2 and −19.1 mL/min/1.73 m2, respectively ( P = .575). Three-year recurrence-free survival rates in these groups were 97.6% and 60.0%, respectively ( P = .001). Conclusions General anesthesia may provide better intermediate outcomes than conscious sedation in treating small renal cell carcinomas with radiofrequency ablation.

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Predictors of immunotherapy-induced immune-related adverse events

Current Oncology ◽

10.3747/co.25.4047 ◽

2018 ◽

Vol 25 (5) ◽

Cited By ~ 14

Author(s):

A. Kartolo ◽

J. Sattar ◽

V. Sahai ◽

T. Baetz ◽

J. M. Lakoff

Keyword(s):

Lung Cancer ◽

Renal Cell Carcinoma ◽

Adverse Events ◽

Small Cell Lung Cancer ◽

Cell Carcinoma ◽

Cell Lung Cancer ◽

Renal Cell ◽

Small Cell ◽

Small Cell Lung ◽

Goodness Of Fit Test

Purpose We aimed to elucidate predictive factors for the development of immune-related adverse events (iraes) in patients receiving immunotherapies for the management of advanced solid cancers.Methods This retrospective study involved all patients with histologically confirmed metastatic or inoperable melanoma, non-small-cell lung cancer, or renal cell carcinoma receiving immunotherapy at the Cancer Centre of Southeastern Ontario. The type and severity of iraes, as well as potential protective and exacerbating factors, were collected from patient charts.ResultsThe study included 78 patients receiving ipilimumab (32%), nivolumab (33%), or pembrolizumab (35%). Melanoma, non-small-cell lung cancer, and renal cell carcinoma accounted for 70%, 22%, and 8% of the cancers in the study population. In 41 patients (53%) iraes developed, with multiple iraes developing in 12 patients (15%). In most patients (70%), the iraes were of severity grade 1 or 2. Female sex [adjusted odds ratio (oradj): 0.094; 95% confidence interval (ci): 0.021 to 0.415; p = 0.002] and corticosteroid use before immunotherapy (oradj: 0.143; 95% ci: 0.036 to 0.562; p = 0.005) were found to be associated with a protective effect against iraes. In contrast, a history of autoimmune disease (oradj: 9.55; 95% ci: 1.34 to 68.22; p = 0.025), use of ctla-4 inhibitors (oradj: 6.25; 95% ci: 1.61 to 24.25; p = 0.008), and poor kidney function of grade 3 or greater (oradj: 10.66; 95% ci: 2.41 to 47.12; p = 0.025) were associated with a higher risk of developing iraes. A Hosmer–Lemeshow goodness-of-fit test demonstrated that the logistic regression model was effective at predicting the development of iraes (chi-square: 1.596; df = 7; p = 0.979).Conclusions Our study highlights several factors that affect the development of iraes in patients receiving immunotherapy. Although future studies are needed to validate the resulting model, findings from the study can help to guide risk stratification, monitoring, and management of iraes in patients given immunotherapy for advanced cancer.

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