[Adrenal metastasis: clinical and pathological aspects].

The clinical and autopsy records of 91 patients who died of various malignancies in January 1980-December 1985 were reviewed with regards to metastatic involvement of the adrenal glands. Metastatic involvement was found in 28/91 i.e. 30.7% of all cases, and in 17/30 cases of lung cancer (56.6%). Although in the majority of cases adrenal metastases were associated with widespread metastatic (terminal) disease, thus questioning the utility of clinical surveillance, in 4/17 cases with lung cancer the adrenals were the only visceral site of metastasis. Symptoms were rarely seen and were in all instances aspecific and attributable to the underlying cancer. Early and accurate identification of suprarenal metastasis would, at least in these cases, be a great help in deciding on the therapeutic approach. Unfortunately our ability to diagnose these metastases is somewhat limited partly because the symptoms are few and aspecific, partly because we lack efficient and economical diagnostic techniques. In fact the simpler laboratory techniques cannot identify early metastatic lesions. However assessment of the adrenals should be part of routine staging and restaging procedures in some neoplasias, for the frequency and clinical relevance of these lesions.