Imaging and management of a small cell lung cancer metastasis/adrenal adenoma collision tumor: a case report and review of the literature (original) (raw)
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Journal of thoracic disease, 2013
The adrenal gland is a common site for metastasis from lung cancer. Adrenal metastases are usually solitary, asymptomatic and diagnosed incidentally during staging of patients with lung cancer. Bilateral adrenal metastases at the time of diagnosis are seen in 3% of lung cancer patients. Large symptomatic bilateral adrenal metastases at presentation are extremely rare and those occurring in the setting of small cell lung cancer (SCLC) have not been reported previously. Herein we describe a 46-year old male patient with SCLC who was symptomatic from large bilateral adrenal metastases at presentation. The patient was successfully treated with conventional platinum based chemotherapy and had no complications related to the large adrenal masses (intratumoral hemorrhage or adrenal insufficiency) either at presentation or subsequently during treatment and follow up.
Bangladesh Journal of Nuclear Medicine
Bilateral adrenal metastases at the time of initial diagnosis of non-small cell lung cancer is a rare phenomenon. In elderly patients with an extra-adrenal malignancy and other nodal metastases, it is difficult to diagnose the etiology of adrenal mass by invasive procedure. Fluorine-18 FDG PET-CT scan can be an effective alternative in this type of patient to characterize adrenal masses as metastatic using several metabolic and imaging parameters in a single setting. Here we present a rare case of synchronus bilateral adrenal metastatic masses found in an elderly gentleman with non-small cell lung cancer (NSCLC) diagnosed during his baseline evaluation by 18F- FDG PET-CT scan. Bangladesh J. Nuclear Med. 24(1&2): 51-56, 2021
Japanese Journal of Clinical Oncology, 2006
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 preoperative chemotherapy and bilateral adrenalectomy.
Adrenal Collision Tumor Diagnosed by F-18 Fluorodeoxyglucose PET/CT
Clin Nucl Med, 2010
Collision tumor is a rare condition in which 2 neoplasms develop in the same area and become intermingled. It is comprised of 2 distinct tissues, with one frequently being a benign entity and the second a malignant metastasis. While uncommonly encountered, collision tumors have been reported in a variety of sites to include the meninges, lungs, liver, bowel, genitourinary tract, and lymph nodes. Their origin is debated with some hypothesizing that the 2 lesions simply occur in contiguity by chance while others propose that the presence of one tumor alters the local environment, making development of a second tumor more likely. We present a 68-yearold woman with a history of left upper lobe adenocarcinoma and ipsilateral hilar lymph node spread of disease (stage IIb). Staging identified an incidental adenoma in the left adrenal gland, which was subsequently confirmed by magnetic resonance imaging (MRI). Several years later, the lesion developed anatomic and metabolic features typical for malignancy, consistent with a collision tumor.
Resection of adrenal metastases from non-small cell lung cancer: a multicenter study
The Annals of Thoracic Surgery, 2001
In recent case reports and limited series, adrenalectomy was recommended for an isolated adrenal metastasis from non-small cell lung cancer (NSCLC). We retrospectively studied patients with a solitary adrenal metastasis from NSCLC who had undergone potentially curative resection in eight centers. Forty-three patients were included. Their adrenal gland metastasis was discovered synchronously with NSCLC in 32 patients, and metachronously in 11. It was homolateral to the NSCLC in 31 patients and contralateral in 12 (p < 0.01). Median survival was 11 months, and 3 patients survived more than 5 years. There was no difference between the synchronous and metachronous groups regarding recurrence rate or survival. Survival was not affected by the homolateral location of the metastasis, the histology of the NSCLC, TNM stage, any adjuvant and neoadjuvant treatment, or, in the metachronous group, a disease-free interval exceeding 6 months. We confirm the possibility of long-term survival after resection of isolated adrenal metastasis from NSCLC, but no clinical or pathologic criteria were detected to identify patients amenable to potential cure.
Outcomes of surgical treatment for isolated adrenal metastasis from non-small cell lung cancer
ecancermedicalscience, 2021
Objective: Long-term survival of patients who undergo surgical resection of isolated adrenal metastasis instead of nonsurgical treatment has shown higher values than those described for stage IVA. The primary endpoint was to evaluate overall survival (OS) of patients with single adrenal metastasis from non-small cell lung cancer (NSCLC), who underwent surgical treatment. The secondary endpoint was to evaluate and compare the OS and disease-free survival (DFS) according to: pathological lung tumour size, histology, lymph node involvement, type of metastasis at the time of diagnosis and laterality of the metastasis according to the primary lung tumour. Methods: From August 2007 to March 2020, 13 patients with isolated adrenal gland metastasis were identified. We performed a descriptive observational study including patients with diagnosed single adrenal gland metastasis of resectable primary lung cancer and no history of other malignant disease. Clinical data obtained included patient demographics, metastases characteristics, laterality of the metastasis, time between surgeries, length of follow-up, survival status, pathological lung tumour size, histology and lymph node involvement. The variables analysed were OS and DFS. Results: Median global OS was 31.9 months (interquartile range (IQR), 19.1-51.4). The 2-and 5-year OS estimated was 54% (95% CI: 29.5%-77.4%) and 36% (95% CI: 13.4%-68.1%), respectively. In patients with NSCLC without mediastinal lymph node involvement, we obtain a median OS of 40 months (IQR, 27.4-51.4) and a 2-and 5-year OS estimated of 75% (95% CI: 43.2%-92.2%) and 50% (95% CI: 18.7%-81.2%), respectively. Recurrence was detected in five patients with a median DFS of 11.9 months (IQR, 6-34.2). Conclusion: The resection of the adrenal metastasis should be considered if the primary lung cancer is resectable. Presence of mediastinal lymph node involvement should be ruled out through invasive staging of the mediastinum before performing adrenal and lung surgery. Proper selection of patients who would benefit from surgery is essential to obtain better survival results.
Adrenalectomy for adrenal metastasis from lung carcinoma
Journal of Surgical Oncology, 1990
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.
European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, 2005
In literature only few reports focused on the resection of solitary adrenal gland metastasis in patients operated on for non-small cell lung cancer (NSCLC). We report our experience on laparoscopic adrenalectomy for suspected or confirmed metachronous solitary adrenal metastasis from NSCLC and discuss its therapeutic role. From June 1993 to March 2003, 14 patients (pts), who had been undergone lung resection for NSCLC, with suspected or confirmed solitary adrenal gland metastasis at the follow-up, underwent 15 laparoscopic adrenalectomy (in 1 patient it was bilateral). All the patients had enlarged adrenal glands at the abdominal ultrasound or CT. All but 2 pts underwent at least 1 adrenal fine needle aspiration. All the patients underwent a careful staging to exclude other sites of metastasis. The adrenal gland was in 6 cases the right, in 9 cases the left. In 7 cases we had a preoperative cytological diagnosis of metastasis. In 1 case adrenalectomy was not performed because of inf...
Outcomes of Patients With Isolated Adrenal Metastasis From Non-Small Cell Lung Carcinoma
The Annals of Thoracic Surgery, 2011
Background. Long-term survival of patients who undergo surgical resection of isolated adrenal metastasis from non-small cell lung cancer (NSCLC) has been reported. The aim of this study was to compare survival of patients who underwent adrenalectomy with those treated nonoperatively, and to analyze clinical characteristics associated with long-term survival. Methods. Between January 1994 and July 2010, 37 patients with isolated adrenal metastasis from NSCLC were identified. Twenty patients underwent adrenalectomy. Patients did not undergo adrenalectomy owing to suspicion of N2 disease, medical comorbidities, or patient preference. Seven patients (35%) treated surgically had tumors that were ipsilateral to their primary tumor, and 8 (40%) had metachronous metastases. Results. Five-year overall survival was 34% for patients treated operatively and 0% for patients treated nonoperatively p ؍ 0.002). Among patients treated with adrenalectomy, patients with ipsilateral metastases had a 5-year survival of 83% compared with 0% for patients with contralateral metastases (p ؍ 0.003). Patients without mediastinal nodal disease had a 5-year survival of 52% compared with 0% for patients with mediastinal nodal disease (p ؍ 0.008). Survival of patients who underwent adrenalectomy for synchronous and metachronous adrenal metastases was not significantly different (p ؍ 0.81). Conclusions. Surgical resection of isolated adrenal metastasis from lung cancer provides a survival benefit in well-selected patients compared with nonoperative management. No patient with contralateral adrenal metastases or mediastinal nodal disease survived long term after adrenalectomy. The time interval between treatment of the primary lung cancer and adrenal metastasis was not significantly associated with survival, but the cohort size was small.
Surgical treatment of solitary adrenal metastases from lung carcinoma
Journal of Surgical Oncology, 1990
Background: Management of solitary adrenal metastasis from non-small cell lung cancer is still debated. Although classically considered incurable, various reports with small numbers of patients have shown that surgical treatment might improve long-term survival. The aim of this study was to review our experience and to identify factors that could affect survival. patients underwent complete resection of an isolated adrenal metastasis after surgical treatment of non-small cell lung cancer. There were 19 men and 4 women, with a mean age of 54 Ϯ 10 years. The diagnosis of adrenal metastasis was synchronous with the diagnosis of nonsmall cell lung cancer in 6 patients and metachronous in 17 patients. The median disease-free interval for patients with metachronous metastasis was 12.5 months (range, 4.5-60.1 months).