CLINICAL AND MORPHOLOGICAL FEATURES OF ADRENAL METASTASES OF RENAL CELL CARCINOMA

Abstract

The problem of adrenal metastases and the need for ipsilateral adrenalectomy during nephrectomy in the patients with renal cell carcinoma has not yet been resolved. To study the clinical and morphological features of adrenal metastases of renal cell carcinoma and to identify a group of patients with a high probability of their development, pathological findings and case histories of 108 patients who underwent surgery included adrenalectomy or adrenal resection were retrospectively examined. Characteristics of patients and tumors in the groups of adrenal metastases and adrenal bulk formations not being cancer metastases were comparatively analyzed. When analyzing the tumors from the group of benign formations of the ipsilateral adrenal gland, it was found that in most cases they were represented by cortical adrenal adenomas without signs of hormonal activity. The histological structure of benign neoplasms was most often represented by clear cell and mixed−cell adenomas, dark−cell adenoma was observed in one case. The patients of this group complained mostly of common a persistent or intermittent rise of blood pressure. Patients with synchronous adrenal metastases of cancer are characterized by large kidney tumors, signs of local spread. According to the study results, it was concluded that the prognostic value in terms of differential diagnosis of adrenal metastases and adenomas in the patients with renal cell carcinoma there was demonstrated only by macroscopic intravenous cancer. The characteristics of the adrenal glands themselves were not objective prognostic parameters for the differential diagnosis between benign and malignant pathology. Ipsilateral adrenalectomy is indicated in the patients with intravenous renal cell carcinoma. Key words: adrenal metastases, renal cell carcinoma, intravenous spread of renal cell carcinoma.