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Metastatic tumours of the adrenal glands: a 30-year experience in a teaching hospital
Abstract
OBJECTIVE: Adrenal metastases are frequently encountered during autopsy but uncommonly present clinically. The aim of this study was to evaluate the clinical and pathological impact of adrenal metastases in a large series of patients. PATIENTS: Four hundred and sixty-four patients (288 men, 176 women) with metastatic disease in the adrenal glands over a 30-year period were included in the study. MEASUREMENTS: The clinical records and pathological features were reviewed. RESULTS: The frequencies of adrenal metastases at autopsies, adrenalectomies and fine-needle aspiration biopsies were 3.1%, 7.5% and 33%, respectively. The lesions were often seen in elderly patients (mean age, 62, SD = 13 years). Many of the metastatic lesions in the adrenal gland occurred shortly after the detection of a primary tumour (mean latent period = 7 months). Four per cent of the adrenal lesions (n = 20) were symptomatic. The symptomatic adrenal lesions, as compared with asymptomatic ones, were bigger and seen in younger patients. Five patients presented with adrenal insufficiency (Addison's disease) and one had massive peritoneal haemorrhage because of metastatic carcinoma. Ninety per cent (n = 421) of the metastatic adrenal tumours were carcinomas and 56% of these were adenocarcinoma. Lung was the most common primary tumour site (35%), followed by the stomach (14%), the oesophagus (12%) and the liver/bile ducts (10%). The adrenal metastases were bilateral in approximately half of the patients (49%, n = 229). The mean diameter of the adrenal metastases was 2 cm (SD = 1.9 cm). The mean weight of the right adrenal gland harbouring the metastasis was 19 g, while that of the left 20 g. The median survival of the 20 patients with symptomatic adrenal lesions was 3 months (range, 0-75 months) after the detection of adrenal metastases. Patients with surgically removed adrenal metastases had slightly better survival rates than those without surgical resection. CONCLUSIONS: A variety of tumours may give rise to adrenal metastases. They are often asymptomatic and detected as part of multiorgan metastases. Symptomatic cases, albeit rare, may occur. Long-term survival may be achieved in selected patients in whom an aggressive surgical approach may be adopted.
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“Of the carcinomas, the most common primary site in 35% of cases was lung, followed by gastrointestinal, kidney, and breast.”
From Adrenal incidentaloma (2020) · cites this paper as [186]
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“Interestingly, bilateral adrenal involvement was noted in almost half the patients in this case series (186).”
From Adrenal incidentaloma (2020) · cites this paper as [186]
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“In one series of 464 patients with metastatic adrenal gland lesions, 90% were carcinomas, with the others being hematological, sarcomas, or melanomas.”
From Adrenal incidentaloma (2020) · cites this paper as [186]
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Metadata
- Authors
- Lam, K. ‐., & Lo, C. ‐.
- Affiliations
- James Cook University (AU)
- Venue
- Clinical Endocrinology
- Publisher
- Wiley
- Published
- 2002-01
- Volume
- 56
- Issue
- 1
- Pages
- 95-101
- ISSN
- 0300-0664 (ISSN-L)
- 1365-2265
- OpenAlex
- W2170682742
- Cited by
- 469
- References
- 44
- Citations by year
- 2026: 13 · 2025: 13 · 2024: 19 · 2023: 17 · 2022: 33 · 2021: 34 · 2020: 36 · 2019: 29 · 2018: 25 · 2017: 24 · 2016: 21 · 2015: 19 · 2014: 24 · 2013: 20 · 2012: 20
- FWCI
- 1.78
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Endocrinology (publishedVersion)
- PubMed (publishedVersion)
- ResearchOnline - JCU (James Cook University) (submittedVersion)
- Griffith Research Online (submittedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Adrenal and Paraganglionic Tumors
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Metastasis and carcinoma case studies
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Keywords
- adrenal metastasis, adrenal gland, adrenal insufficiency, Addison's disease, adrenocortical carcinoma, adrenal adenocarcinoma, primary tumor site, lung cancer, bilateral adrenal metastases, autopsy findings, fine-needle aspiration, metastatic disease
- MeSH terms
- Adenocarcinoma, Adolescent, Adrenal Gland Neoplasms, Adrenalectomy, Adult, Aged, Aged, 80 and over, Autopsy, Biopsy, Needle, Carcinoma, Child, Child, Preschool, Female, Humans, Infant, Lymphoma, Male, Melanoma, Middle Aged, Retrospective Studies, Sarcoma, Survival Rate, Leukemic Infiltration
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