Adrenalectomy for Isolated Metastasis in Five Patients with Lung Cancer: Single Centre Experience and Review of the Literature

Isolated adrenal metastasis from non-small cell lung cancer (NSCLC) is a rare event. Nonsurgical treatment of a solitary adrenal metastasis is associated with poor survival. However, in the aspect of long-term survival, the role of adrenalectomy for isolated metastasis is unclear. Here, we reported our experience with surgical treatment of solitary adrenal metastasis in patients with NSCLC whose primary tumor control were achieved and reviewed current literature. Between the 2001 and 2009, five patients underwent curative adrenalectomy (in 1 patient it was bilateral) for suspected solitary adrenal metastasis after surgical treatment of NSCLC. The pathologic examination confirmed in 3 cases a NSCLC metastasis while in 2 cases it was a benign lesion. In the follow-up period, all of the 3 patients with adrenal metastasis had recurrence of NSCLC. Recurrence was local (in the operated adrenal bed) in 2 patients. Palliative radiotherapy focalized to adrenal bed was given to one of the patient with local recurrence. This patient is currently alive 51 months after the adrenalectomy. The other patient with local recurrence died 24 months after the adrenalectomy. Recurrence was systemic (brain and contralateral adrenal gland) in 1 patient who was treated with contralateral adrenalectomy and surgical resection of the cranial metastasis followed by cranial radiotherapy. The patient who underwent bilateral adrenalectomy for metastatic lung cancer died of wide-spread metastatic disease, 79 months after the adrenalectomy. In conclusion, survival benefit can be obtained after complete resection of isolated adrenal metastasis in patients with NSCLC. Therefore, resection of isolated adrenal metastasis should be considered if the primary NSCLC is resectable