Doyya Modar, Alloush Ghina, Alloush Mazen
Faculty of Medicine, Damascus University, Damascus, Syria.
Department of Urology, Al-Assad University Hospital, Damascus, Syria.
J Med Case Rep. 2025 Jul 9;19(1):331. doi: 10.1186/s13256-025-05396-8.
Kidney cancer is a highly prevalent malignancy, consistently ranking among the top ten cancers affecting both men and women, and its mortality has been increasing globally. Renal cell carcinoma is the most common type and has a tendency to metastasize, with a predilection for spreading to other organs. While the adrenal gland is located adjacent to the kidney, metastasis of renal cell carcinoma to the adrenal gland is considered rare compared with other sites such as the lungs, liver, and bones. In addition, the occurrence of metastasis to the contralateral adrenal gland is an exceedingly rare phenomenon.
A 57-year-old Arabic female patient presented with intermittent hematuria over a period of several months. The patient's medical and surgical history revealed no significant findings. Laboratory tests revealed normal results, with the exception of elevated aldosterone levels and a high aldosterone renin ratio, despite a normal blood pressure reading. Further investigations revealed the coexistence of renal cell carcinoma and adrenal adenoma on the left side, along with adrenal mass on the right side, which confirmed its metastatic nature after resection and pathological study. As a result, a left nephrectomy and right adrenalectomy were subsequently conducted. Postsurgery, the aldosterone level normalized, confirming the secretory function of the metastasized renal carcinoma in the right adrenal gland.
The secretion of aldosterone from an adrenal metastasis arising from renal cell carcinoma is a rare phenomenon that healthcare providers should bear in mind during differential diagnosis. It is imperative to conduct thorough investigations and extended research to understand the potential complications associated with this unique presentation.
肾癌是一种高度常见的恶性肿瘤，在影响男性和女性的十大癌症中一直名列前茅，其死亡率在全球范围内呈上升趋势。肾细胞癌是最常见的类型，有转移倾向，尤其容易扩散到其他器官。虽然肾上腺与肾脏相邻，但与肺、肝和骨等其他部位相比，肾细胞癌转移至肾上腺被认为较为罕见。此外，转移至对侧肾上腺的情况极为罕见。
一名57岁的阿拉伯女性患者，数月来间歇性出现血尿。患者的病史和手术史均未发现明显异常。实验室检查结果除醛固酮水平升高和醛固酮肾素比值偏高外均正常，尽管血压读数正常。进一步检查发现左侧存在肾细胞癌和肾上腺腺瘤，右侧有肾上腺肿块，切除并经病理研究后证实其为转移性。因此，随后进行了左肾切除术和右肾上腺切除术。术后，醛固酮水平恢复正常，证实转移性肾细胞癌在右侧肾上腺具有分泌功能。
肾细胞癌肾上腺转移分泌醛固酮是一种罕见现象，医疗人员在鉴别诊断时应予以关注。必须进行全面检查和深入研究，以了解与这种独特表现相关的潜在并发症。
