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The utility of 18F-FDG PET/CT for the diagnosis of adrenal metastasis in lung cancer. Nucl Med Commun 2017; 38:1117-1124. [DOI: 10.1097/mnm.0000000000000757] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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2
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Gao XL, Zhang KW, Tang MB, Zhang KJ, Fang LN, Liu W. Pooled analysis for surgical treatment for isolated adrenal metastasis and non-small cell lung cancer. Interact Cardiovasc Thorac Surg 2016; 24:1-7. [DOI: 10.1093/icvts/ivw321] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Revised: 07/26/2016] [Accepted: 08/19/2016] [Indexed: 11/15/2022] Open
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3
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Abstract
In the absence of persuasive findings from the trials outlined earlier, the available evidence supports treating patients with a solitary site of M1 disease with induction chemotherapy followed by resection of all sites of disease as long as patients understand that this multimodality approach has not been proven to be superior to either surgery alone or chemotherapy alone.
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Affiliation(s)
- Robert J Downey
- Thoracic Service, Department of Surgery, Memorial Hospital, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10021, USA.
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4
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Taira N, Kawabata T, Ichi T, Kushi K, Yohena T, Kawasaki H, Ishikawa K. Long-term survival after surgical treatment of metachronous bilateral adrenal metastases of non-small cell lung carcinoma. AMERICAN JOURNAL OF CASE REPORTS 2014; 15:444-6. [PMID: 25317919 PMCID: PMC4206476 DOI: 10.12659/ajcr.891027] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Patient: Male, 70 Final Diagnosis: Bilateral adrenal metastasis Symptoms: — Medication: — Clinical Procedure: Surgery Specialty: Surgery
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Affiliation(s)
- Naohiro Taira
- Department of General Surgery, National Hospital Organization, Okinawa National Hospital, Ginowan, Japan
| | - Tsutomu Kawabata
- Department of General Surgery, National Hospital Organization, Okinawa National Hospital, Ginowan, Japan
| | - Takaharu Ichi
- Department of General Surgery, National Hospital Organization, Okinawa National Hospital, Ginowan, Japan
| | - Kazuaki Kushi
- Department of General Surgery, National Hospital Organization, Okinawa National Hospital, Ginowan, Japan
| | - Tomofumi Yohena
- Department of General Surgery, National Hospital Organization, Okinawa National Hospital, Ginowan, Japan
| | - Hidenori Kawasaki
- Department of General Surgery, National Hospital Organization, Okinawa National Hospital, Ginowan, Japan
| | - Kiyoshi Ishikawa
- Department of General Surgery, National Hospital Organization, Okinawa National Hospital, Ginowan, Japan
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5
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Stone WZ, Wymer DC, Canales BK. Fluorodeoxyglucose-positron-emission tomography/computed tomography imaging for adrenal masses in patients with lung cancer: review and diagnostic algorithm. J Endourol 2014; 28:104-11. [PMID: 23927734 PMCID: PMC3880901 DOI: 10.1089/end.2013.0380] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND AND PURPOSE Positron-emission tomography/computed tomography (PET/CT) with fluorine-18 fluorodeoxyglucose (FDG) is used as first-line staging for patients with newly diagnosed non-small cell lung cancer (NSCLC). Our purpose was to review the accuracy of FDG-PET/CT to predict adrenal gland metastasis, explain the causes for false-positive PET, and provide a diagnostic algorithm. PATIENTS AND METHODS Two patients with incidentally discovered lung masses were found to have hypermetabolic adrenal activity by FDG-PET/CT with maximal standard uptake value (SUV) of 4.5 and 6.5. A MEDLINE search was performed on the topic of FDG-PET/CT, adrenal gland metastasis, and NSCLC. Literature was reviewed with regard to diagnosis, accuracy, outcomes, and alternative imaging or diagnostic strategies. RESULTS Both patients underwent transabdominal laparoscopic adrenalectomy and were found to have nodular hyperplasia without evidence of adrenal tumor. A total of seven articles containing 343 patients were identified as having pertinent oncologic information for NSCLC patients with adrenal lesions. Sensitivity and specificity of PET/CT for distant metastasis was 94% and 85%, respectively, but only 13% (44/343) of these patients had histologically confirmed adrenal diagnoses. Based on this, a diagnostic algorithm was created to aid in decision making. CONCLUSIONS Although PET/CT has high sensitivity and specificity for adrenal metastasis in the setting of NSCLC, adrenal biopsy or other secondary imaging should be considered to confirm the finding. Adrenalectomy in lieu of biopsy may have both diagnostic and therapeutic benefit in cases where the adrenal mass is ≥10 mm with high PET maximum SUV (≥3.1) and SUV ratios (>2.5), where washout CT or chemical shift MRI is positive, or where percutaneous biopsy is deemed too difficult or unsafe.
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Affiliation(s)
- W. Zachary Stone
- Department of Urology, University of Florida, Gainesville, Florida
| | - David C. Wymer
- Department of Radiology, University of Florida, Gainesville, Florida
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6
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Pituitary FDG uptake in a patient of lung cancer with bilateral adrenal metastases causing adrenal cortical insufficiency. Clin Nucl Med 2011; 36:731-2. [PMID: 21716036 DOI: 10.1097/rlu.0b013e31821a26bf] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
A 64-year-old woman with history of lung cancer and left adrenal gland metastasis was referred for FDG PET/CT to assess the response to target therapy and local radiotherapy treatment. In addition to bilateral adrenal gland FDG uptake lesions, the PET/CT also showed focal FDG uptake in pituitary gland with standardized uptake value of 3.9. Adrenocorticotropic hormone serum level was 439 pg/mL (normal <46 pg/mL), and serum cortisol level was 6 μg/dL (normal range, 5-25 μg/dL). The image and serum test results suggested the diagnosis of lung cancer, with bilateral adrenal metastases causing adrenal cortical insufficiency with secondary pituitary gland hyperplasia.
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Muñoz A, López-Vivanco G, Mañé JM, Fernández R, Díaz-Aguirregoitia J, Saiz M, Barceló R. Metastatic non-small-cell lung carcinoma successfully treated with pre-operative chemotherapy and bilateral adrenalectomy. Jpn J Clin Oncol 2006; 36:731-4. [PMID: 17071712 DOI: 10.1093/jjco/hyl101] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Metastatic non-small-cell lung cancer is a common condition with a dismal prognosis. Although palliative chemotherapy improves survival and quality of life, nearly all patients die of progressive disease. Metastatic involvement of adrenal glands is not rare, but usually reflects widespread dissemination. Selected patients with single adrenal metastasis may be cured with surgery, although the level of evidence comes from single cases reports and short retrospective series. Here we report a patient with bilateral adrenal metastases from previously resected non-small-cell lung cancer, who remains free of disease four years after pre-operative chemotherapy and bilateral adrenalectomy.
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Affiliation(s)
- Alberto Muñoz
- Department of Medical Oncology, Hospital de Cruces, Osakidtza, Basque Country, Spain.
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8
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Abstract
BACKGROUND AND OBJECTIVES Adrenal metastases from lung cancer usually indicate systemic disease and incurability. However, a small subset of patients with isolated adrenal metastases may achieve long-term survival with aggressive surgical resection of the adrenal gland. To clarify the role of adrenalectomy for metastatic lung cancer, we undertook a review of the published literature on this topic. METHODS The English-language medical literature was searched for papers reporting surgical resection of adrenal metastases from lung cancer. Eleven articles were retrieved and their data pooled for analysis. RESULTS Sixty patients (including seven previously reported from our institution) formed the basis of this collective review. Thirty-two patients pooled from small series and case reports had a median survival of 24 months, and approximately one-third were 5-year survivors. Twenty-eight patients reported in two large series had a less favorable survival (approximately 14 months median survival). CONCLUSIONS Surgical resection of isolated adrenal metastases from lung cancer appears to have a modest survival advantage over nonoperative therapy, and it occasionally results in long-term survival. However, the relatively encouraging survival results reported in the literature could be related to careful patient selection for this aggressive therapy, publication bias in favor of positive treatment outcomes, or a combination of the two. Nevertheless, the results are encouraging enough to justify further investigation of this aggressive treatment strategy. Practical guidelines for management are proposed.
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Affiliation(s)
- A L Beitler
- Department of Thoracic Surgical Oncology, Roswell Park Cancer Institute, Buffalo, New York 14263-0001, USA
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9
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Bendinelli C, Lucchi M, Buccianti P, Iacconi P, Angeletti CA, Miccoli P. Adrenal masses in non-small cell lung carcinoma patients: is there any role for laparoscopic procedures? J Laparoendosc Adv Surg Tech A 1998; 8:119-24. [PMID: 9681423 DOI: 10.1089/lap.1998.8.119] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Surgical treatment of adrenal metastases from non-small cell lung carcinoma (NSCLC) is a current and controversial issue. We analyze our experience with the laparoscopic treatment of NSCLC solitary adrenal metastases. In the last 4 years, six patients underwent laparoscopic adrenalectomy for suspected solitary NSCLC metastasis. A metastasis was removed in four patients and a cortical adenoma in two. Laparoscopy with intraoperative ultrasonography was demonstrated to be an excellent procedure for the diagnostic and therapeutic management of the patient affected by a solitary adrenal metastasis from NSCLC. Longer follow-up and a larger series are necessary to enable definitive conclusions to be drawn about the impact on survival of laparoscopic adrenalectomy for NSCLC metastasis.
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Affiliation(s)
- C Bendinelli
- Department of Surgery, University of Pisa, Italy
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Urschel JD, Finley RK, Takita H. Long-term survival after bilateral adrenalectomy for metastatic lung cancer: a case report. Chest 1997; 112:848-50. [PMID: 9315827 DOI: 10.1378/chest.112.3.848] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Selected patients with solitary metastases from non-small cell lung cancer can benefit from an aggressive treatment approach that includes resection of the metastases. This approach has been used for solitary adrenal metastases, but successful long-term treatment of bilateral adrenal metastases has not been previously reported. This is the report of a patient with bilateral adrenal metastases from lung cancer who is disease-free 9 years after bilateral adrenalectomy and chemotherapy. From this evidence, one may hypothesize that adrenal metastases are occasionally lymphatic in origin and that metastases with this route of spread are more amenable to aggressive curative treatment than adrenal metastases of hematogenous origin.
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Affiliation(s)
- J D Urschel
- Department of Thoracic Surgery and Oncology, Roswell Park Cancer Institute, Buffalo, NY 14263-0001, USA
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11
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Reyes L, Parvez Z, Nemoto T, Regal AM, Takita H. Adrenalectomy for adrenal metastasis from lung carcinoma. J Surg Oncol 1990; 44:32-4. [PMID: 2342373 DOI: 10.1002/jso.2930440108] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
In the past 3 years, five patients with lung carcinoma were found to have enlarged adrenal glands without any evidence of distant metastasis. The patients were treated with adrenalectomy. The cases are presented in order to discuss optimal methods of diagnosis and treatment for this condition.
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Affiliation(s)
- L Reyes
- Department of Thoracic Surgery and Oncology, Roswell Park Cancer Institute, Buffalo, NY 14263
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12
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Cancer de pulmon con invasion de pared (excepto tumor de pancoast). Arch Bronconeumol 1986. [DOI: 10.1016/s0300-2896(15)32024-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Lam WK, So SY, Ip M, Yu DY. Cyclic combination chemotherapy in advanced adenocarcinoma of the lung: comparison of two FAM schedules. Cancer Chemother Pharmacol 1985; 14:282-3. [PMID: 3922641 DOI: 10.1007/bf00258136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Forty patients with advanced adenocarcinoma of the lung were treated by two FAM chemotherapy schedules. Group A (20 patients) received Futraful, adriamycin, and mitomycin C, and group B (20 patients) received 5-fluorouracil, adriamycin, and mitomycin C. The response/stabilization rate was greater for group B (4 partial responses + 4 cases of stable disease) than for group A (no responders + 5 cases of stable disease), and the median survival was longer for group B (32 weeks) than for group A (22 weeks), although the differences did not reach statistical significance in either case (P greater than 0.05). Myelotoxicity was mild in both schedules. Further studies of the two FAM schemes at an escalated dose would be worthwhile.
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Abstract
A retrospective study was made of 480 Chinese patients with proven bronchogenic carcinoma, the top cancer in Hong Kong. The male-to-female sex ratio was low (1.9:1) and the female mortality rate ranked amongst the world's highest. The four major histologic types accounted for 87% of the cases: 39% epidermoid, 12% small cell anaplastic, 29% adenocarcinoma, and 7% large cell anaplastic. History of smoking was associated with epidermoid and small cell anaplastic carcinoma only. The commonest symptoms were anorexia and malaise (67%) and cough (51%). Overall our patients presented late and only 30 (6%) had curative surgery. The relatively rare occurrence of deep vein thrombosis (0.7%) is in keeping with the known low incidence of venous thrombosis in Chinese. Adenocarcinoma was a distinct group characterized by its preponderance in females (43%), lack of association with smoking habit (61% female cases being nonsmokers), high frequency of neurologic manifestation (21%) and clinical, roentgenographic, and bronchoscopic features of a predominantly centrally situated tumor. Possible etiologic factors for the high and still increasing incidence of adenocarcinoma are discussed.
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Abstract
Fourteen cases of bronchogenic carcinoma were found in 191 patients with chronic lymphocytic leukemia seen at the Rosewell Park Memorial Institute, Buffalo, NY, from 1951 to 1976. Four of these were not diagnosed until the time of autopsy. There was an average lag of nine months between the onset of symptoms and signs suggestive of bronchogenic carcinoma and its diagnosis. In patients with chronic lymphocytic leukemia, a high index of suspicion for bronchogenic carcinoma is necessary fo its early detection.
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MESH Headings
- Adult
- Aged
- Antineoplastic Agents/therapeutic use
- Carcinoma, Bronchogenic/complications
- Carcinoma, Bronchogenic/drug therapy
- Carcinoma, Bronchogenic/radiotherapy
- Carcinoma, Squamous Cell/complications
- Carcinoma, Squamous Cell/drug therapy
- Carcinoma, Squamous Cell/radiotherapy
- Drug Therapy, Combination
- Humans
- Leukemia, Lymphoid/complications
- Leukemia, Lymphoid/drug therapy
- Lung Neoplasms/complications
- Lung Neoplasms/drug therapy
- Lung Neoplasms/radiotherapy
- Male
- Middle Aged
- Neoplasms, Multiple Primary/drug therapy
- Neoplasms, Multiple Primary/radiotherapy
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Marbella PC, Takita H, Lane WW, Preffer FI. Squamous cell carcinoma of the lung. Clinicopathologic study. Chest 1977; 71:497-501. [PMID: 856547 DOI: 10.1378/chest.71.4.497] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
This study was undertaken to investigate the diagnostic, therapeutic, and prognostic features of squamous cell carcinoma of the lung. The overall five-year survival rate for 734 patients was 5 percent, with a median survival of 5.9 months. Surgical excision for early-stage disease was particularly effective therapy. In 151 of 201 patients having surgical excision, the resections were deemed curative. Other modes of therapy proved ineffective, although a combination of radiation and chemotherapy provided cure in one of 39 patients; that patient is alive today after 11 years and three months.
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Marabella PC, Elias LL, Takita H, Minowada J. Migration inhibition test in lung cancer patients. J Surg Oncol 1975; 7:479-81. [PMID: 1186264 DOI: 10.1002/jso.2930070607] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Twenty patients with primary carcinoma of the lung were tested with migration inhibition test, using extract of cultured lung carcinoma of large cell type. Eight of 10 patients with localized disease had positive inhibition, while all 10 of the patients with disseminated disease had negative inhibition (x2, p less than 0.005). Two cases of large cell carcinoma (localized) showed extremely positive inhibition which may suggest the presence of cell type specific lung carcinoma antigen.
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