Adrenal Metastases

Abstract

Adrenal gland is one of metastatic areas of malignant tumours. Adrenal metastasis was identified as between 13-17% in post-mortem autopsy series of metastatic tumours. Adrenal metastasis is mostly observed in the lung and primary renal tumours. However, isolated adrenal metastasis was observed in less than 1% of the cases. Characteristics of the masses in cross-sectional monitoring methods are the best way of showing the difference between benign and malignant adrenal masses. In this retrospective study, we have planned to compare the AI (adrenal incidentaloma) patients with and without malignancy among the cases of AI.Characteristics of the 366 patients, who were detected with AI through MRI or CT found from the retrospective examination of the internal medicine and endocrinology clinic of our hospital records between 2010-2013, were evaluated. In the examination of the adrenal masses sizes of the patients, the largest sized mass of the patients with bilateral adrenal masses was examined. Monitoring characteristics and primary malignancy status were considered when retrospectively distinguishing the AI patients whether benign or malignant.It was detected from the records that 233 of the patients (69.8%) of our study had benign adrenal masses while the remaining 113 patients (30,8%) had metastatic adrenal masses. 220 (60.2%) men and 146 (39.8%) female patients were added to our study. It was observed that 54.9% of the patients with benign adrenal masses and 71.7% of the patients with adrenal metastasis were male (p <0.01). 53 of the patients (46.9%), considered as adrenal metastases, were lung originated while the other frequently seen malignancies were endometrial cancer (9%), breast cancer (5.3%), colon cancer (8.8%), prostate cancer (4.4%) respectively. While unilateral adenoma was detected in 41.5% of the patients admitted with benign adrenal masses, the percentage was found as 20.4% in the cases regarded as adrenal metastasis (p<0.01). On the other hand, bilateral adrenal masses were detected in 25 patients (17.89%). The ratio of the applications with bilateral adrenal masses was found higher in the group of patients with adrenal metastasis (p<0.01).The possibility of adrenal metastasis must be taken into consideration for the admitted patients with adrenal masses. Besides, the adrenal glands must be examined in detail via monitoring methods in primary malignancies cases especially in lung cancer cases. It must be given privilege to the possibility of malignancy for the applications with bilateral adrenal masses.

Keywords

• Adrenal metastase, adrenal incidentaloma

Adrenal Metastazlar

Öz

Adrenal bez, malign tümörlerin sık metastatik alanlarındandır. Metastatik tümörlerin postmortem yapılan otopsi serilerinde %13-17 arasında adrenal metastaz tespit edilmiştir. En sık olarak akciğer ve primer böbrek tümörlerinde adrenal metastaz görülmektedir. Ancak izole adrenal metastaz %1’den az vakada görülmüştür. Benign ve malign adrenal kitleler arasındaki farkı en iyi gösterme yolu kesitsel görüntüleme yöntemlerinde kitlelerin karakteristik özellikleridir. Biz bu retrospektif çalışmada adrenal insidenteloması (Aİ) olan vakaların arasından malignitesi olan ve olmayan Aİ hastaları karşılaştırmayı planladık. 2010-2013 tarihleri arasında retrospektif olarak hastanemiz iç hastalıkları ve endokrinoloji polikliniği kayıtları incelenerek MRI yada CT ile Aİ tespit edilen 366 hastanın özellikleri değerlendirildi. Hastaların adrenal kitle boyutları değerlendirilirken bilateral adrenal kitlesi olan hastalarda kitlelerden en büyüğünün boyutu değerlendirmeye alındı. Retrospektif olarak hastaların Aİ benign ve malign ayrımı yapılırken görüntüleme özellikleri ve primer malignite durumu değerlendirildi.Çalışmamızdaki hastaların 233’ü (%69,8) benign adrenal kitle, geriye kalan 113’ünün (%30,8) ise metastatik adrenal kitle olduğu kayıtlardan tespit edildi. Çalışmamıza 220 (%60,2) erkek ve 146 (%39.8) kadın hasta dahil edildi. Benign adrenal kitlesi olan hastaların %54,9 ve adrenal metastazlı hastalarda %71,7 oranında erkek cinsiyet görüldü (p

Anahtar Kelimeler

• Adrenal metastazlar, adrenal insidentiloma

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