Metastatic Disease to the Adrenal Gland

Overview

Certain cancers can spread (metastasize) from other parts of the body to the adrenal gland, including kidney cancer (renal cell carcinoma), melanoma (a type of skin cancer), lung cancer, colon cancer, and lymphoma. The best treatment for metastatic cancer is usually systemic therapy like chemotherapy, however doctors will sometimes recommend removing the adrenal gland. Adrenalectomy may be recommended when the primary disease is well controlled and the adrenal is the only site of metastatic disease, if the patient is having significant symptoms from a large adrenal tumor, or if a diagnosis needs to be made and the adrenal is the easiest site to perform a biopsy. It is uncommon for metastatic cancer to appear in the adrenal gland before the primary site is known.

Signs and Symptoms

Most patients with adrenal metastases do not have signs or symptoms (i.e. are asymptomatic). Occasionally patients may have back or abdominal pain due to a large or rapidly growing tumor. In rare cases where both adrenal glands are involved, patients may develop a problem where the adrenal glands do not make enough cortisol (i.e. adrenal insufficiency).

Treatment

The most effective treatment for adrenal metastases is to treat the primary cancer, usually with chemotherapy and/or radiation therapy. If adrenal insufficiency is present, then steroid hormone replacement should be given. For patients in whom the adrenal is the only site of metastatic disease and the primary cancer is well controlled, the adrenal metastasis may be treated by either radiation therapy or surgical removal. In these cases, adrenalectomy can often be done using minimally invasive techniques. (See Adrenal Surgery)