Metastases from a renal cell carcinoma to the adrenal gland are relatively uncommon. Moudouni et al identified factors predictive of adrenal metastases in a patient with renal cell carcinoma. The authors are from Hospital Pontchaillou in Morocco.
Factors associated with adrenal metastases:
(1) large renal cell carcinoma arising in the upper pole showing extracapsular spread
(2) TNM tumor stage T3 or T4, including tumors showing venous invasion
(3) multifocal renal cell carcinoma
Indications for ipsilateral adrenalectomy during resection of a renal cell carcinoma:
(1) identification of intra-adrenal tumor in a preoperative CT scan
(2) gross involvement of the adrenal gland is seen at surgery
If ipsilateral adrenal metastases are present, then the prognosis for the patient is poor and more aggressive management is indicated.
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