Simultaneous bilateral adrenal metastases from renal cell carcinoma. Surgical implications and review of the literature.

We report a case of left-side renal cell carcinoma with contemporary bilateral adrenal involvement discovered preoperatively with computerized tomography and other imaging techniques. Surgical treatment consisted of radical nephrectomy with a nearly total contralateral adrenalectomy and the unroofing of a lower pole renal cyst. Postoperative cortisone acetate replacement was instituted. The surgical implications of renal cell carcinoma with metastasis are also discussed.