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Filizoglu N, Ozguven S, Dede F, Turoglu HT, Erdil TY. Solitary adrenal metastasis of breast cancer on [ 68Ga]Ga-DOTA-TATE PET/CT. Rev Esp Med Nucl Imagen Mol 2024:500061. [PMID: 39270844 DOI: 10.1016/j.remnie.2024.500061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2024] [Revised: 09/04/2024] [Accepted: 09/05/2024] [Indexed: 09/15/2024]
Affiliation(s)
- N Filizoglu
- Department of Nuclear Medicine, University of Health Sciences, Kartal Dr. Lutfi Kirdar City Hospital, Istanbul, Turkey.
| | - S Ozguven
- Department of Nuclear Medicine, Marmara University Pendik Training and Research Hospital, Istanbul, Turkey
| | - F Dede
- Department of Nuclear Medicine, Marmara University Pendik Training and Research Hospital, Istanbul, Turkey
| | - H T Turoglu
- Department of Nuclear Medicine, Marmara University Pendik Training and Research Hospital, Istanbul, Turkey
| | - T Y Erdil
- Department of Nuclear Medicine, Marmara University Pendik Training and Research Hospital, Istanbul, Turkey
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2
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Puvvada P, Nirhale DS, Gaudani RH, Mane P. Bilateral Infiltrating Ductal Carcinoma With Adrenal Metastasis: A Rare Case Report. Cureus 2024; 16:e65635. [PMID: 39205706 PMCID: PMC11350619 DOI: 10.7759/cureus.65635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2024] [Accepted: 07/29/2024] [Indexed: 09/04/2024] Open
Abstract
Adrenal gland metastasis is rare, often associated with invasive lobular carcinoma (ILC) rather than infiltrating ductal carcinoma (IDC). This report presents a case of a 43-year-old female with bilateral breast IDC and metastasis to the adrenal gland, with bilateral axillary and supraclavicular node involvement. Initial symptoms included a nipple discharge and a palpable lump. Diagnostic imaging and biopsy confirmed IDC, grade 2, with positive estrogen receptor (ER) and progesterone receptor (PR) status and negative human epidermal growth factor receptor 2 (HER2) status. The patient is undergoing chemotherapy and radiotherapy, with adrenalectomy planned post chemotherapy. The case underscores the need for early diagnosis and rapid treatment to improve outcomes, highlighting the paucity of data on managing solitary adrenal metastasis from IDC. Further research and clinical trials are essential to develop standardized treatment protocols.
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Affiliation(s)
- Pragna Puvvada
- General Surgery, Dr. D. Y. Patil Medical College, Hospital & Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed to be University) Pimpri, Pune, IND
| | - Dakshayani S Nirhale
- General Surgery, Dr. D. Y. Patil Medical College, Hospital & Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed to be University) Pimpri, Pune, IND
| | - Romi H Gaudani
- General Surgery, Dr. D. Y. Patil Medical College, Hospital & Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed to be University) Pimpri, Pune, IND
| | - Praveen Mane
- General Surgery, Dr. D. Y. Patil Medical College, Hospital & Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed to be University) Pimpri, Pune, IND
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3
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Zhang Y, Sun C, Yau V, Chen S, Yang Q, Chen W, Lowe S, Bentley R, Ouyang Z. Clinical Features and Prognosis of Uncommon Metastatic Breast Cancer: A Retrospective Analysis of 82 Cases. Technol Cancer Res Treat 2023; 22:15330338231184990. [PMID: 37386809 PMCID: PMC10333636 DOI: 10.1177/15330338231184990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 05/27/2023] [Accepted: 06/06/2023] [Indexed: 07/01/2023] Open
Abstract
With the improvement of diagnostic techniques, numerous uncommon metastases derived from breast cancer were reported. However, very few studies explored the clinical characteristics and prognostic patterns of these patients. A total of 82 cases of uncommon metastatic breast cancer (MBC) registered at our hospital from January 1, 2010, to July 1, 2022, were selected for this retrospective study. The diagnoses of uncommon metastases were based on pathology, and the potential prognostic indicators (overall survival [OS], uncommon disease-free interval [uDFI], and remaining survival [RS]) were estimated. The uncommon metastases involved distant soft tissue, parotid gland, thyroid, digestive system, urinary system, reproductive system, bone marrow, and pericardium. Stepwise multivariate Cox regression analysis indicates age ≤ 35 is an independent risk factor of poor outcome of OS, uDFI, and RS in uncommon MBC patients. Meanwhile, uncommon metastasis combined with common visceral metastasis is an independent risk factor for poor RS of uncommon MBC patients, with a hazard ratio of 6.625 (95% confidence interval = 1.490-29.455, P = .013). Post hoc pairwise comparisons showed that uncommon MBC patients who developed bone-only metastasis survived longer than those concomitant with common visceral metastasis (P = .029). Although the incidence is low, uncommon MBC may involve multiple metastatic sites. The delayed diagnosis of uncommon metastases could lead to systemic progression of the disease. However, patients who only develop uncommon metastasis have a significantly better prognosis than that of those combined with common visceral metastasis. Even for those complicated by bone-only metastasis, active treatment of bone metastases can still achieve substantially longer survival.
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Affiliation(s)
- Yusi Zhang
- The First Affiliated Hospital of Xiamen
University, School of Medicine, Xiamen University, Xiamen, Fujian,
China
| | - Chenyu Sun
- The Second Affiliated Hospital of Anhui
Medical University, Hefei, China
| | - Vicky Yau
- Columbia University Irving Medical
Center, New York, NY, USA
| | - Shuanglong Chen
- The First Affiliated Hospital of Xiamen
University, School of Medicine, Xiamen University, Xiamen, Fujian,
China
| | - Qingmo Yang
- The First Affiliated Hospital of Xiamen
University, School of Medicine, Xiamen University, Xiamen, Fujian,
China
| | - Wenlin Chen
- The First Affiliated Hospital of Xiamen
University, School of Medicine, Xiamen University, Xiamen, Fujian,
China
| | - Scott Lowe
- Kansas City University, Kansas City, MO, USA
| | | | - Zhong Ouyang
- The First Affiliated Hospital of Xiamen
University, School of Medicine, Xiamen University, Xiamen, Fujian,
China
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4
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Chen RY, Goh RY, Leung HT, Cheng S, Tan VKM, Chia CLK, Goo JTT, Ong MW. Clinical Significance of Radiologically Detected Small Indeterminate Extra-Mammary Lesions in Breast Cancer Patients. Eur J Breast Health 2022; 18:252-257. [PMID: 35855201 PMCID: PMC9255656 DOI: 10.4274/ejbh.galenos.2022.2022-1-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 04/30/2022] [Indexed: 12/01/2022]
Abstract
Objective Patients with breast cancer who have indeterminate extra-mammary lesions, for example in lung, liver or bone, without other metastatic lesions pose a clinical dilemma regarding subsequent management. This study aimed to investigate the prevalence, characteristics and outcomes of such lesions detected on initial staging imaging, and address the clinical significance of these incidental findings. Materials and Methods Medical records of patients with newly diagnosed breast cancer who underwent computed tomography scans and bone scintigraphy between January 1, 2015 and June 30, 2021 were reviewed. Patients with indeterminate extra-mammary lesions on imaging were included. Patients with obvious metastatic disease were excluded. Lesion characteristics, breast cancer staging, duration of follow-up and natural history of disease progression were analysed. Results The study included 52 patients with indeterminate lesions on pre-operative imaging. The median follow-up duration was 14 (range: 6-41) months. The most common site of occurrence of indeterminate lesions was the lung (60.9%) followed by the liver (26.1%). Forty-six had lesions that remained stable (88.5%), while six (11.5%) had progression to metastatic disease. Out of these six, only two (3.8%) developed metastasis in the same site as the original indeterminate lesion, whereas the remaining four developed metastases in other sites. Conclusion Patients with breast malignancy found to have indeterminate extra-mammary lesions without obvious distant metastasis on initial staging scans are associated with a small risk of subsequently developing metastatic disease. Although most of these lesions remain quiescent, surveillance imaging is recommended because a small but significant proportion of patients with such lesions eventually harbour actual metastatic disease.
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Affiliation(s)
- Rachel Yanlin Chen
- Department of General Surgery, Khoo Teck Puat Hospital, Yishun, Singapore
| | - Rui Ying Goh
- Department of General Surgery, Khoo Teck Puat Hospital, Yishun, Singapore
| | - Hoi Ting Leung
- Department of General Surgery, Khoo Teck Puat Hospital, Yishun, Singapore
| | - Stephanie Cheng
- Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Outram, Singapore
| | - Veronique Kiak Mien Tan
- Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Outram, Singapore
| | | | | | - Marc Weijie Ong
- Department of General Surgery, Khoo Teck Puat Hospital, Yishun, Singapore
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Illuminati G, Pasqua R, D'Ermo G, Girolami M, Cerbelli B, D'Amati G, Carboni F, Fiori E. Results of Adrenalectomy for Isolated, Metachronous Metastasis of Breast Cancer: A Retrospective Cohort Study. Front Surg 2021; 8:671424. [PMID: 34179068 PMCID: PMC8219849 DOI: 10.3389/fsurg.2021.671424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 05/17/2021] [Indexed: 11/23/2022] Open
Abstract
Background and Aim: Metachronous, isolated adrenal metastases from breast cancer are extremely rare. The aim of this study was to evaluate the results of adrenalectomy as a treatment of this uncommon condition. Methods: Twelve female patients (median age: 68 years) underwent 13 adrenalectomies for isolated, metachronous metastases of breast cancer. Ten resections were performed thorugh open surgery and two were preformed through a laparoscopic approach. As main study endpoints, postoperative mortality, postoperative morbidity and disease-free survival were considered. Median length of follow-up was 40 months. Results: Postoperative mortality was absent. Postoperative morbidity was 17%: one patient presented a postoperative pneumothorax requiring drainage and one patient required re-hospitalization 8 days after contralateral adrenalectomy for electrolyte imbalance. Two patients died of recurrent metastatic disease, 28 and 33 months respectively after adrenalectomy. One patient remained alive with hepatic metastases at 32 months from resection of adrenal recurrence. All in all, disease-free survival at 48 months was 75%. Conclusions: Adrenalectomy for metachronous, isolated metastases of breast cancer can be performed with no postoperative mortality and minimal postoperative morbidity, enabling good long-term disease-free survival.
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Affiliation(s)
- Giulio Illuminati
- Department of Surgical Sciences, University of Rome "La Sapienza", Rome, Italy
| | - Rocco Pasqua
- Department of Surgical Sciences, University of Rome "La Sapienza", Rome, Italy
| | - Giuseppe D'Ermo
- Department of Surgery, "Pietro Valdoni", University of Rome "La Sapienza", Rome, Italy
| | - Marco Girolami
- Department of Surgical Sciences, University of Rome "La Sapienza", Rome, Italy
| | - Bruna Cerbelli
- Department of Medical-Surgical Sciences, Biotechnologies and Pathology, University of Rome "La Sapienza", Rome, Italy
| | - Giulia D'Amati
- Department of Medical-Surgical Sciences, Biotechnologies and Pathology, University of Rome "La Sapienza", Rome, Italy
| | - Fabio Carboni
- Department of Surgery, Regina Elena Cancer Institute, Rome, Italy
| | - Enrico Fiori
- Department of Surgery, "Pietro Valdoni", University of Rome "La Sapienza", Rome, Italy
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6
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Naik MM, Nestasie MJ, Gordon MB. Recurrent Invasive Ductal Breast Carcinoma Presenting as Primary Adrenal Insufficiency with Adrenal Crisis. AACE Clin Case Rep 2020; 6:e50-e53. [DOI: 10.4158/accr-2019-0331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 11/12/2019] [Indexed: 11/15/2022] Open
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Abstract
RATIONALE Breast cancer is the most commonly diagnosed malignancies in females. The most common sites of metastasis are bone, lung, liver, and brain. Gastrointestinal and adrenal gland metastasis from breast cancer are rare. Simultaneous metastases are extremely rare. Therefore, it is critically important to choose proper examination and treatment since the rapid diagnosis and primary treatment can significantly affect the survival of patients. To the best of our knowledge, this was the first case of initial dual metastasis. PATIENT CONCERNS The patient had a history of left breast cancer, and she underwent left breast-conserving surgery with sentinel lymph node biopsy 2 years ago. She was hospitalized in our center with the complaints of a stomach and lower back pain, which started suddenly and was progressively increased for half a month. DIAGNOSIS Computed tomography, gastroscopy, and immunohistochemical staining, especially GATA3 and mammaglobin, confirmed that there was simultaneous gastric and adrenal metastases. INTERVENTIONS She was eligible for the IMpassion131 clinical trials, a Phase 3 randomized, double-blind, placebo-controlled trial under treatment with atezolizumab/palcebo plus paclitaxel as adjuvant-therapy. OUTCOMES She was still undergoing the therapy and waiting for the further evaluation. LESSONS In order to better understand metastatic pathways of breast carcinoma, publications of individual patient cases diagnosed with rare metastatic sites should be encouraged, especially for the simultaneous rare metastatic sites. This might improve our understanding of metastatic behavior of breast cancer and promote further clinical research.
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8
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Doleschal B, Petzer A, Aichberger KJ. Adrenal crisis in metastatic breast cancer. BMJ Case Rep 2017; 2017:bcr-2017-220284. [DOI: 10.1136/bcr-2017-220284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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9
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Ampuja M, Alarmo E, Owens P, Havunen R, Gorska A, Moses H, Kallioniemi A. The impact of bone morphogenetic protein 4 (BMP4) on breast cancer metastasis in a mouse xenograft model. Cancer Lett 2016; 375:238-244. [DOI: 10.1016/j.canlet.2016.03.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 03/03/2016] [Accepted: 03/03/2016] [Indexed: 02/06/2023]
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HE TAO, LIU JIAJU, LI YIFAN, JIN LU, SUN SHUOLEI, NI LIANGCHAO, MAO XIANGMING, YANG SHANGQI, LAI YONGQING. Left adrenal gland metastasis of breast invasive ductal carcinoma: A case report. Mol Clin Oncol 2016; 4:859-862. [PMID: 27123296 PMCID: PMC4840554 DOI: 10.3892/mco.2016.814] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Accepted: 02/25/2016] [Indexed: 02/05/2023] Open
Abstract
The majority of the metastatic lesions of the adrenal gland normally originate from lung cancer, colon malignant tumor, renal cell carcinoma and melanoma. However, adrenal gland metastasis that metastasize from breast invasive ductal carcinoma are extremely rare. The present study reported a rare case of left adrenal gland metastasis in a 35-year-old female who was diagnosed as breast carcinoma 5 years ago with a mass located on the left adrenal gland, which was detected during a routine examination. The patient was asymptomatic and adrenal gland computed tomography revealed a mass in the left adrenal gland. Definitive preoperative diagnosis failed to be established. Left adrenal gland laparoscopic adrenalectomy was performed and the diagnosis of adrenal gland metastasis of breast invasive ductal carcinoma was confirmed by pathological and immunohistochemical examination. The patient remained in good condition by the time of writing.
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Affiliation(s)
- TAO HE
- Department of Urology, Peking University Shenzhen Hospital, Shenzhen 518036, P.R. China
- Guangzhou Medical University, Guangzhou 511436, P.R. China
| | - JIAJU LIU
- Department of Urology, Peking University Shenzhen Hospital, Shenzhen 518036, P.R. China
- Shantou University Medical College, Guangdong 515041, P.R. China
| | - YIFAN LI
- Department of Urology, Peking University Shenzhen Hospital, Shenzhen 518036, P.R. China
- Anhui Medical University, Anhui, Hefei 230032, P.R. China
| | - LU JIN
- Department of Urology, Peking University Shenzhen Hospital, Shenzhen 518036, P.R. China
- Anhui Medical University, Anhui, Hefei 230032, P.R. China
| | - SHUOLEI SUN
- Department of Urology, Peking University Shenzhen Hospital, Shenzhen 518036, P.R. China
| | - LIANGCHAO NI
- Department of Urology, Peking University Shenzhen Hospital, Shenzhen 518036, P.R. China
| | - XIANGMING MAO
- Department of Urology, Peking University Shenzhen Hospital, Shenzhen 518036, P.R. China
| | - SHANGQI YANG
- Department of Urology, Peking University Shenzhen Hospital, Shenzhen 518036, P.R. China
- Correspondence to: Professor Yongqing Lai or Professor Shangqi Yang, Department of Urology, Peking University Shenzhen Hospital, 1120 Lianhua Road, Shenzhen 518036, P.R. China, E-mail: , E-mail:
| | - YONGQING LAI
- Department of Urology, Peking University Shenzhen Hospital, Shenzhen 518036, P.R. China
- Correspondence to: Professor Yongqing Lai or Professor Shangqi Yang, Department of Urology, Peking University Shenzhen Hospital, 1120 Lianhua Road, Shenzhen 518036, P.R. China, E-mail: , E-mail:
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11
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Barros NA, Ferreira A, Rocha MJ, Castro L. Unusual breast cancer metastasis. BMJ Case Rep 2015; 2015:bcr-2014-209125. [PMID: 26082098 DOI: 10.1136/bcr-2014-209125] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Nuno André Barros
- Departments of Obstetrics and Gynecology, Hospital de Braga, Braga, Portugal
| | - Arlindo Ferreira
- Departments of Obstetrics and Gynecology, Hospital de Braga, Braga, Portugal
| | - Maria José Rocha
- Departments of Obstetrics and Gynecology, Hospital de Braga, Braga, Portugal
| | - Luis Castro
- Departments of Obstetrics and Gynecology, Hospital de Braga, Braga, Portugal
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Eren OO, Ordu C, Selcuk NA, Akosman C, Ozturk MA, Özkan F, Gokce Ö, Oyan B. Bilateral synchronous adrenal metastasis of invasive ductal carcinoma treated with multimodality therapy including adrenalectomy and oophorectomy. J Oncol Pharm Pract 2014; 22:157-60. [PMID: 25227232 DOI: 10.1177/1078155214551314] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A 38-year-old woman presented with a mass in the left breast. Biopsy of the lesion revealed invasive ductal carcinoma. Bilateral adrenal metastasis was detected in whole body positron emission tomography scanning. Needle biopsy of the left adrenal lesion proved infiltration of malignant cells from breast carcinoma. After eight cycles of neoadjuvant (preoperative) chemotherapy, mastectomy, bilateral adrenalectomy, and bilateral oopherectomy were performed. No further hormonal treatment was recommended due to the resection of both adrenal glands and ovaries. The patient is still followed without any sign of progression. To our knowledge, this is the first case representing multimodality approach to breast cancer with bilateral synchronous adrenal metastasis. Patients with oligometastatic disease may benefit from aggressive treatment including local therapies.
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Affiliation(s)
- Orhan Onder Eren
- Department of Medical Oncology, Faculty of Medicine, Yeditepe University, Istanbul, Turkey
| | - Cetin Ordu
- Department of Medical Oncology, Faculty of Medicine, Bilim University, Istanbul, Turkey
| | - Nalan A Selcuk
- Department of Nuclear Medicine, Faculty of Medicine, Yeditepe University, Istanbul, Turkey
| | - Cengiz Akosman
- Department of Medical Oncology, Medical Park Hospital, Ordu, Turkey
| | - Mehmet Akif Ozturk
- Department of Internal Medicine, Faculty of Medicine, Yeditepe University, Istanbul, Turkey
| | - Ferda Özkan
- Department of Pathology, Faculty of Medicine, Yeditepe University, Istanbul, Turkey
| | - Özcan Gokce
- Department of General Surgery, Faculty of Medicine, Yeditepe University, Istanbul, Turkey
| | - Basak Oyan
- Department of Medical Oncology, Faculty of Medicine, Yeditepe University, Istanbul, Turkey
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Shoji S, Usui Y, Nakano M, Hanai K, Sato H, Uchida T, Terachi T. Surgical management of metastatic adrenal tumors: Decision-making factors in imaging. Oncol Lett 2010; 1:967-971. [PMID: 22870096 DOI: 10.3892/ol.2010.183] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2010] [Accepted: 08/27/2010] [Indexed: 11/06/2022] Open
Abstract
The present study aimed to clarify decision-making factors based on imaging for laparoscopic adrenalectomy (LA) or open adrenalectomy (OA) for adrenal metastasis (AM) based on our previous experience. From November 2003 to November 2006, 11 adrenalectomies were performed for AM for malignancies such as lung cancer, renal cell carcinoma (RCC) and breast cancer at Tokai University Hospital. A diagnosis of AM for these malignancies was suspected whenever a newly diagnosed adrenal mass was located, characterized by a basal computed tomography (CT) density superior to 10 Hounsfield units, strong or heterogeneous vascular enhancement following contrast injection and/or increasing size in sequential imaging studies. There was no evidence of extra-AM. The approach to surgical management using LA or OA was determined on the basis of CT and/or magnetic resonance imaging. The patients were reviewed every 2 or 3 months by physical examination and systemic CT. We analyzed the decision-making factors based on imaging for surgical management with LA or OA from the results of oncological outcome, imaging, intraoperative and pathohistological findings. In this study, 9 patients underwent 11 adrenalectomies (9 laparoscopic and 2 open procedures). Non-small cell lung cancer was the most common primary malignancy (5 adrenalectomies of 4 patients), followed by RCC (4 adrenalectomies of 4 patients) and breast cancer (2 adrenalectomies of 1 patient). The median tumor size for the LA group was 3.1±0.7 cm (range 2.1-4.3) and for the OA group, 6.1±0.8 cm (5.5 and 6.7 cm) (p=0.001). The operative time for the LA group was 127±42 min (range 90-215) and for the OA group, 224±47 min (190 and 257 min) (p=0.018). Blood loss for the LA group was 49±63 g (range 3-207) and for the OA group, 340±10 g (333 and 347 g) (p<0.001). No complications were noted and no conversion of LA to OA occurred. All 9 adrenal tumors selected for LA were removed safely without strong adhesion to the surrounding tissue. Two adrenal tumors removed by OA had a strong adhesion to the surrounding tissue. All 9 patients had complete resection, without capsular disruption and a negative margin in the pathological findings. No port-site and local recurrences occurred. No patients presented with local relapse or port-site metastasis. Disease-free survival rate for the LA group was 57% and for the OA group, 50% (p=0.661). LA is a less invasive treatment than OA for AM. However, for complete resection, OA should be selected for cases where resection by LA is difficult. Therefore, in the decision making towards the appropriate surgical management with LA or OA, it is important to closely assess pre-operative imaging. Imaging features supporting OA include no detection of fatty tissue between the tumor and proximal organs, tumors with an irregular contour, large tumors and tumors with a cystic component.
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Affiliation(s)
- Sunao Shoji
- Department of Urology, Tokai University School of Medicine, Tokyo 192-0032, Japan
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