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Adrenal metastases.
[adrenal incidentaloma]
The
adrenal
gland
is
a
frequent
location
for
metastatic
spread
of
a
various
number
of
malignant
tumors
.
Among
all
tumors
,
carcinoma
of
lung
,
breast
,
ovary
and
malignant
melanoma
count
to
the
most
frequent
ones
.
In
nononcological
and
unselected
populations
,
the
prevalence
of
adrenal
metastases
is
0
-
21
%
.
The
metastases
are
mostly
discovered
in
patients
during
their
follow-up
carried
out
in
consequence
of
their
antecedent
malignant
disease
.
A
malignant
disease
in
adrenal
gland
may
occasionally
manifest
as
a
solitary
metastasis
referred
to
as
adrenal
incidentaloma
.
If
the
malignant
disease
is
disseminated
at
the
time
of
adrenal
mass
diagnosis
,
no
further
differentiation
of
lesion
is
necessary
as
it
does
not
influence
the
further
therapeutic
process
.
If
the
dissemination
is
not
present
,
further
differentiation
of
adrenal
lesion
is
essential
.
CT
and
MRI
characteristics
of
the
adrenal
mass
play
the
key
role
in
the
differential
diagnosis
.
The
examination
of
adrenal
overproduction
is
not
necessary
in
case
of
known
adrenal
metastasis
except
when
performing
tests
in
order
to
rule
out
the
catecholamine
overproduction
.
In
case
of
bilateral
metastases
,
adrenal
insufficiency
should
be
also
excluded
.
Surgical
treatment
is
indicated
in
cases
of
solitary
metastasis
.
The
further
management
of
patients
with
adrenal
metastases
belongs
to
the
oncologist
.
The
prognosis
of
the
disease
is
usually
very
poor
with
average
survival
rate
of
three
months
(
Fig
.
2
,
Ref
.
34
)
.
