Metastasi surrenaliche da carcinoma broncogeno: esiste un'opzione chirurgica?

Background. Personal experience in the treatment of adrenal metastases from non-small cell lung carcinoma (NSCLC) is reported and a comparison with the literature data is made. Methods. Twelve adrenal neoplasms were observed in a group of 136 cases of surgically treated NSCLC lung tumors. The suspected metastasis was identified in 7 cases during initial admission of the patient, while the condition developed following the intervention in the other 5 cases. In 5 cases of radical resection of the primary lung tumor which presented suspected metastases, adrenalectomy was performed (in 3 cases contemporarily with the primary tumor, and successively in the other 2 cases). Results. Histology confirmed the diagnosis of adrenal metastase in 3 cases, while the adrenal mass was benign in the other 2 cases. There was no significant data regarding morbidity or mortality of the patients surgically treated and length of hospitalization was similar to patients not subjected to adrenal resection. Follow-up revealed satisfactory long-term survival with average values above those of patients with adrenal metastases not subjected to resection. Conclusions. In conclusion, an aggressive approach to adrenal metastases, when present, is suggested. In fact, this method can lead to longer survival and immediate retro-staging of the neoplastic disease with semplification of follow-up.