Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2022 Jul 29;5(6):446-450.
doi: 10.1002/iju5.12511. eCollection 2022 Nov.

Metastatic neuroendocrine carcinoma of right adrenal gland successfully treated with laparoscopic adrenalectomy after multimodal therapy

Yusuke Yamagata  1 , Takashige Abe  1 , Naoya Iwahara  1 , Kohichi Takada  2 , Yasuhiro Hida  3 , Emi Takakuwa  4 , Hiroshi Kikuchi  1 , Ryuji Matsumoto  1 , Takahiro Osawa  1 , Nobuo Shinohara  1
Affiliations
Case Reports

Metastatic neuroendocrine carcinoma of right adrenal gland successfully treated with laparoscopic adrenalectomy after multimodal therapy

Yusuke Yamagata et al. IJU Case Rep. .

Abstract

Introduction: We report a case of laparoscopic adrenalectomy in a salvage setting after multiple chemotherapies for neuroendocrine carcinoma.

Case presentation: A 49-year-old man was diagnosed with unknown primary carcinoma with single brain metastasis, and right supraclavicular and mediastinal lymph node metastases. After stereotactic radiotherapy of the brain metastasis and systemic chemotherapy, lymphadanectomy was performed. The pathologic diagnosis was neuroendocrine carcinoma. At 11 months after surgery, computed tomography revealed right adrenal metastasis. Local radiotherapy initially resulted in complete remission. However, adrenal recurrence was noted 10 months later. Laparoscopic adrenalectomy was performed with curative intent. The patient is currently alive without recurrence at 20 months after the operation.

Conclusion: Adrenalectomy can become a treatment option if other metastases are well-controlled with systemic therapy. Surgical elimination of oligometastases can offer long-term disease control in selected patients as part of a multimodal approach.

Keywords: adrenal gland neoplasms; adrenalectomy; combined modality therapy; laparoscopic surgery; metastasectomy; salvage therapy.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
(a)‐(d) Pathologic findings of the right supraclavicular lymph node biopsy specimen (a) Hematoxylin and eosin staining (b) TTF‐1 is positive. (c) ALK is negative. (d) PD‐L1 is weak positive. (e)‐(h) Pathologic findings of the right adrenal tumor (e) A well‐circumscribed white lesion is found in the right adrenal gland. (red circle). (f) Low‐magnification view of the right adrenal gland. (g) Hematoxylin and eosin staining (h) Chromogranin A, which is specific for neuroendocrine tumors, is partially positive.
Fig. 2
Fig. 2
FDG PET‐CT findings. Fluorodeoxyglucose uptake is shown in the right adrenal gland at 11 months after right supraclavicular and mediastinal lymph node dissection.
Fig. 3
Fig. 3
Transition of ProGRP during the treatment (normal range: 0–80.9 pg/mL).
Fig. 4
Fig. 4
Enhanced computed tomography before adrenalectomy. Right adrenal metastasis remains after local radiotherapy and multiple chemotherapies.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Vazquez BJ, Richards ML, Lohse CM et al. Adrenalectomy improves outcomes of selected patients with metastatic carcinoma. World J. Surg. 2012; 36: 1400–5. - PubMed
    1. Chen JY, Ardestani A, Tavakkoli A. Laparoscopic adrenal metastasectomy: appropriate, safe, and feasible. Surg. Endosc. 2014; 28: 816–20. - PubMed
    1. Goto T, Inoue T, Kobayashi T et al. Feasibility of laparoscopic adrenalectomy for metastatic adrenal tumors in selected patients: a retrospective multicenter study of Japanese populations. Int. J. Clin. Oncol. 2020; 25: 126–34. - PubMed
    1. Moreno P, de la Quintana Basarrate A, Musholt TJ et al. Adrenalectomy for solid tumor metastases: results of a multicenter European study. Surgery 2013; 154: 1215–22. discussion 1222–1213. - PubMed
    1. Howell GM, Carty SE, Armstrong MJ et al. Outcome and prognostic factors after adrenalectomy for patients with distant adrenal metastasis. Ann. Surg. Oncol. 2013; 20: 3491–6. - PMC - PubMed

Publication types