The significance of adrenal metastases from lung carcinoma

Kocijančič, Igor; Vidmar, Ksenija; Zwitter, Matjaž; Snoj, Marko

doi:10.1053/ejso.2002.1372

Cited by 26 publications

(15 citation statements)

References 11 publications

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“…In humans with lung cancer, metastases to adrenals are considered to occur early mainly by lymphogenous spread and develop later by hematogenous routes. 11,12 In domestic animals, hypoadrenocorticism secondary to metastatic or multicentric neoplasms has only been reported in two cats with lymphoma. 29 In this study, a single dog with lymphoma was diagnosed with hypoadrenocorticism; none of the other animals in the study were tested to evaluate adrenal function in the presence of adrenal metastases.…”

Section: Discussionmentioning

confidence: 99%

Metastatic Tumors to the Adrenal Glands in Domestic Animals

Labelle

Cock

2005

Vet Pathol

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Abstract. Although metastases to the adrenals are common in humans, they have not been thoroughly studied in animals. The purpose of this retrospective study was to document the types of malignant tumors that metastasize to canine, feline, equine, and bovine adrenals, and the rate at which they do so. The average rate of adrenal involvement in metastatic cancer was 112/534 (21.0%) in dogs, 12/81 (14.8%) in cats, 18/67 (26.9%) in horses, and 5/16 (31.3%) in cattle. In dogs, 26 different tumor types metastasized to the adrenals. Pulmonary, mammary, prostatic, gastric, and pancreatic carcinomas, and melanoma had the highest rates of metastasis to the adrenal glands in dogs. Hemangiosarcoma and melanoma had high rates of adrenal involvement in horses. In cats and cattle, relevant data were only available for lymphoma. Adrenal metastases usually occurred in the late stages of the disease. One dog had developed Addison's disease (hypoadrenocorticism) secondary to lymphoma. Metastatic lesions represented 126/472 (26.7%) of canine, 12/20 (60.0%) of feline, 21/80 (26.3%) of equine, and 5/9 (55.5%) of bovine adrenal neoplasms. This study shows that adrenal glands should be thoroughly examined during both clinical work-up and postmortems when disseminated neoplasia is suspected.Key words: Adrenal glands; cats; cattle; dogs; endocrine diseases; horses; neoplasm metastasis; neoplasms.Metastatic tumor is the most common neoplastic lesion in the adrenal glands of humans and is especially common with lung, breast, and gastric carcinomas, and melanoma. 1,[13][14][15]24,34,36 They are the fourth most common site of metastasis after lung, liver, and bone. 15 The common occurrence of metastases to the adrenals is thought to be related to the rich sinusoidal blood supply. 13,16 Adrenal metastases only infrequently cause hypoadrenocorticism, possibly because an estimated 90% of the adrenal cortex must be compromised before abnormal gland function is detectable and hyperplasia of the remaining adrenal may compensate for the loss of tissue. 4,13,16 When hypoadrenocorticism does occur, the resulting clinical signs may be overlooked and wrongly attributed to nonspecific effects of widespread neoplastic disease. 13,16,25,30,36 Also, the use of treatment protocols that include steroids may mask symptoms and complicate the diagnosis of hypoadrenocorticism. 25,30,36 In domestic animals, metastases to the adrenal glands have only been occasionally described, mostly as single cases. 2,3,[5][6][7][8]10,[19][20][21][22][23][26][27][28][29][31][32][33]35,[37][38][39] To the authors' knowledge, there are no published reports on the rate of adrenal involvement in metastatic disease for specific tumor types in domestic animals. Hypoadrenocorticism due to tumor spread has been reported in two cats but has not been reported in other animals. 29 In this study, we describe the rate and features of metastatic lesions to the adrenal glands of domestic animals. Materials and MethodsThe records of canine, feline, equine, and bovine patients admitted to the ...

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Section: Discussionmentioning

confidence: 99%

Metastatic Tumors to the Adrenal Glands in Domestic Animals

Labelle

Cock

2005

Vet Pathol

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“…Kocijancic et al [17] described a group of 50 patients with nonsmall cell lung cancer in whom adrenal metastases were detected. In 20 patients metastases were ipsilateral, in 15 contralateral, and in 15 bilateral.…”

Section: Originmentioning

confidence: 99%

Surgical management of adrenal metastases

Sancho

Triponez

Montet

et al. 2011

Langenbecks Arch Surg

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A patient with suspected adrenal metastasis should be considered a candidate for adrenalectomy when: (a) control of extra-adrenal disease can be accomplished, (b) metastasis is isolated to the adrenal gland(s), (c) adrenal imaging is highly suggestive of metastasis or the patient has a biopsy-proven adrenal malignancy, (d) metastasis is confined to the adrenal gland as assessed by a recent imaging study, and (e) the patient's performance status warrants an aggressive approach. In properly selected patients, laparoscopic (or retroperitoneoscopic) adrenalectomy is a feasible and safe option.

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“…Another 3 predictive factors have been discussed controversially.First,ipsilateraladrenalmetastasesweresuggested to be associated with more limited disease and favourable outcomes [19,20]. Our findings and 2 other studies did not supportthishypothesis [7,10].Unfortunately,thesiteofadrenal metastases has been reported inconsistently in the longterm survivors reported in table 2.…”

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confidence: 55%

“…Insummary,patientswithsolitaryadrenalmetastasesseemto have a longer median survival and 5-year survival of 12-31 monthsand11-31%,respectively [7,9,10,20,27],compared to the general population with stage M1b disease who typi-cally have a median survival of 10-12 months and a 5-year survivaloflessthan4% [2].Apartfromthesurgicalintervention,patientselectionandindolenttumourbiologyarelikely tocontributetoimprovedoutcomes.Unfortunately,controlled studies to address this question are lacking. We recommend careful staging including PET-CT scan.…”

Section: Resultsmentioning

confidence: 99%

Surgical Resection of Isolated Adrenal Metastases in Patients with Non-Small Cell Lung Cancer: A Single-Institution Experience and Review of the Literature

Bastian¹,

Clerici²,

Neuweiler

et al. 2011

Onkologie

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Background: In non-small cell lung cancer (NSCLC), the benefits of resection of solitary adrenal metastases for survival and the identification of patients most likely to benefit from adrenalectomy are unknown. Patients and Methods: We retrospectively reviewed clinico-pathological factors and outcomes in 4 NSCLC patients treated with adrenalectomy at our centre. We reviewed the published literature with a focus on long-term survivors in order to formulate treatment recommendations. Results: Local pathological staging showed stages IA–IIA. All had a performance status (PS) of 0. The median age was 56 years (range: 53–58 years). Adrenal metastases were detected by positron emission tomography-computed tomography (PET-CT) in 3 patients. Median time from lobectomy to occurrence of metachronous adrenal metastases was 12.3 months (11–14 months). The perioperative mortality was zero. All patients recurred systemically after adrenalectomy within 2–49 months. 3 patients died due to systemic progression 6–15 months after adrenalectomy. 1 patient is alive with pulmonary relapse 49 months after adrenalectomy. Conclusions: Resection of solitary adrenal metastases in selected good-PS NSCLC patients with minimal local nodal involvement from the primary tumour is associated with low morbidity and may offer a chance for long-term disease-free survival in a small subset of patients. Careful pre-operative staging including PET-CT is warranted.

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The significance of adrenal metastases from lung carcinoma

Cited by 26 publications

References 11 publications

Metastatic Tumors to the Adrenal Glands in Domestic Animals

Metastatic Tumors to the Adrenal Glands in Domestic Animals

Surgical management of adrenal metastases

Surgical Resection of Isolated Adrenal Metastases in Patients with Non-Small Cell Lung Cancer: A Single-Institution Experience and Review of the Literature

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