CLINICAL CASES AND TREATMENT TACTICS FOR METASTASES TO THE CONTRALATERAL ADRENAL GLAND IN RENAL CELL CARCINOMA

Abstract

Renal cell carcinoma (RCC) is the third most common, but is the most lethal urological cancer. Approximately 30% of renal cell carcinomas (RCC) present as stage IV disease with various metastases (lung, liver, bones, brain), ipsilateral adrenal metastases found 1-10%, contralateral adrenal gland is rarely (0,7%) involved. This article presents information about two patients with renal cell carcinoma, during the initial examination of which metastasis was revealed in the contralateral adrenal gland. The first patient underwent a right-sided radical nephrectomy with transperitoneal access and adrenalectomy on the left. The second patient, 19 months before contacting us, underwent radical nephrectomy on the left with ipsilateral adrenalectomy, despite the fact that then metastasis was detected in the contralateral adrenal gland. The patient underwent contralateral adrenalectomy with the use of replacement steroid therapy in order to prevent adrenal crisis. In conclusion, it should be noted that metastasectomy with RCC complicated by contralateral adrenal metastases improves the results of surgical treatment of the IV stage of patients.