Resection of an isolated adrenal gland metastasis from a non-small lung carcinoma (NSCLC) may result in a good long-term survival. It is essential to operate only on carefully selected patients.
Patient selection: non-small cell lung cancer with an isolated adrenal metastasis.
The adrenal metastasis may be classified as synchronous or metachronous.
Time from Diagnosis of the Lung Primary to Diagnosis of the Adrenal Lesion
Adrenal Metastasis
<= 6 months
synchronous
> 6 months
metachronous
A patient with a metachronous adrenal metastasis may have a better survival than a patient with a synchronous metastasis.
A patient with a NSCLC and an isolated adrenal metastasis may be a candidate for adrenalectomy if:
(1) the lung tumor is small and resectable
(2) there are no metastases to N2 or N3 nodes
(3) there are no other distant metastases identified after a careful workup
(4) the adrenal lesion is a true metastasis and not a benign enlargement
The workup of the patient may include:
(1) MRI: to detect intra-cranial metastases
(2) PET scan: to identify extra-cranial metastases
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