Adrenal metastases: Difference between revisions
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{{SK}} Synonym 1; Synonym 2; Synonym 3 | {{SK}} Synonym 1; Synonym 2; Synonym 3 | ||
==Overview== | ==Overview== | ||
==Pathophysiology== | ==Pathophysiology== | ||
*The pathogenesis of adrenal metastases is characterized by metastases from renal cell carcinoma, melanoma, lung cancer, colorectal cancer, breast cancer and lymphoma. | *The pathogenesis of adrenal metastases is characterized by metastases from renal cell carcinoma, melanoma, lung cancer, colorectal cancer, breast cancer and lymphoma. | ||
*On gross pathology, unilateral, small asymptomatic lesion are characteristic findings of adrenal metastases. | *On gross pathology, unilateral, small asymptomatic lesion are characteristic findings of adrenal metastases. | ||
==Differentiating [disease name] from other Diseases== | ==Differentiating [disease name] from other Diseases== | ||
*Adrenal metastases must be differentiated from other diseases that cause tumors in adrenal gland such as: | *Adrenal metastases must be differentiated from other diseases that cause tumors in adrenal gland such as: | ||
| Line 28: | Line 15: | ||
:*Adrenal cyst | :*Adrenal cyst | ||
:*Nonfunctional pheochromocytoma | :*Nonfunctional pheochromocytoma | ||
==Epidemiology and Demographics== | ==Epidemiology and Demographics== | ||
* Adrenal metastases are thought to be present in up to 27% of patients with known malignant epithelial tumours at autopsy. | * Adrenal metastases are thought to be present in up to 27% of patients with known malignant epithelial tumours at autopsy. | ||
== Natural History, Complications and Prognosis== | == Natural History, Complications and Prognosis== | ||
*If left untreated, 20-35% of patients with cancer may progress to develop adrenal metastases. | *If left untreated, 20-35% of patients with cancer may progress to develop adrenal metastases. | ||
*Common complication of adrenal metastases are central necrosis with adrenal hemorrhage and paraneoplastic leukemoid reaction. | *Common complication of adrenal metastases are central necrosis with adrenal hemorrhage and paraneoplastic leukemoid reaction. | ||
== Diagnosis == | == Diagnosis == | ||
=== Symptoms === | === Symptoms === | ||
*Symptoms of adrenal metastases may include the following: | *Symptoms of adrenal metastases may include the following: | ||
| Line 67: | Line 28: | ||
:*[[Weakness]] | :*[[Weakness]] | ||
:*[[Weight loss]] | :*[[Weight loss]] | ||
=== Physical Examination === | === Physical Examination === | ||
*Patients with | *Patients with adrenal metastases usually appear cachectic. | ||
*Physical examination may be remarkable for: | *Physical examination may be remarkable for: | ||
:*[ | :*[Abdominal mass] | ||
=== Laboratory Findings === | === Laboratory Findings === | ||
*There are no specific laboratory findings associated with | *There are no specific laboratory findings associated with adrenal metastases. | ||
===Imaging Findings===. | ===Imaging Findings===. | ||
*CT is the imaging modality of choice for adrenal metastases. | *CT is the imaging modality of choice for adrenal metastases. | ||
| Line 88: | Line 40: | ||
:* T1: usually exhibit low signal intensity | :* T1: usually exhibit low signal intensity | ||
:* T2: usually exhibit high signal intensity | :* T2: usually exhibit high signal intensity | ||
:* T1 C+ (Gd): usually has progressive enhancement after administration of contrast material | :* T1 C+ (Gd): usually has progressive enhancement after administration of contrast material. | ||
== Treatment == | == Treatment == | ||
=== Medical Therapy === | === Medical Therapy === | ||
| Line 99: | Line 47: | ||
*Adrenalectomy in conjunction with chemotherapy is the most common approach to the treatment of adrenal metastases if primary disease is well controlled and the only site of metastasis if adrenal gland. | *Adrenalectomy in conjunction with chemotherapy is the most common approach to the treatment of adrenal metastases if primary disease is well controlled and the only site of metastasis if adrenal gland. | ||
=== Prevention === | === Prevention === | ||
*There are no primary preventive measures available for | *There are no primary preventive measures available for adrenal metastases. | ||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
[[Category:oncology]] | [[Category:oncology]] | ||
Revision as of 17:21, 6 April 2016
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Ammu Susheela, M.D. [2]
Synonyms and keywords: Synonym 1; Synonym 2; Synonym 3
Overview
Pathophysiology
- The pathogenesis of adrenal metastases is characterized by metastases from renal cell carcinoma, melanoma, lung cancer, colorectal cancer, breast cancer and lymphoma.
- On gross pathology, unilateral, small asymptomatic lesion are characteristic findings of adrenal metastases.
Differentiating [disease name] from other Diseases
- Adrenal metastases must be differentiated from other diseases that cause tumors in adrenal gland such as:
- Nonfunctional adenoma
- Adrenal metastasis
- Primary carcinoma in adrenal glands
- Adrenal cyst
- Nonfunctional pheochromocytoma
Epidemiology and Demographics
- Adrenal metastases are thought to be present in up to 27% of patients with known malignant epithelial tumours at autopsy.
Natural History, Complications and Prognosis
- If left untreated, 20-35% of patients with cancer may progress to develop adrenal metastases.
- Common complication of adrenal metastases are central necrosis with adrenal hemorrhage and paraneoplastic leukemoid reaction.
Diagnosis
Symptoms
- Symptoms of adrenal metastases may include the following:
Physical Examination
- Patients with adrenal metastases usually appear cachectic.
- Physical examination may be remarkable for:
- [Abdominal mass]
Laboratory Findings
- There are no specific laboratory findings associated with adrenal metastases.
===Imaging Findings===.
- CT is the imaging modality of choice for adrenal metastases.
- On CT, adrenal metastases may demonstrate less than 50% washout.
- On MRI, adrenal metastases may demonstrate:
- T1: usually exhibit low signal intensity
- T2: usually exhibit high signal intensity
- T1 C+ (Gd): usually has progressive enhancement after administration of contrast material.
Treatment
Medical Therapy
- The mainstay of therapy for adrenal metastases is chemotherapy.
Surgery
- Adrenalectomy in conjunction with chemotherapy is the most common approach to the treatment of adrenal metastases if primary disease is well controlled and the only site of metastasis if adrenal gland.
Prevention
- There are no primary preventive measures available for adrenal metastases.