A Case Report of Surgically Removed Metachronous Adrenal Metastasis from Sigmoid Colon Cancer

Toru Kawai, Tatsuo Hattori, Yoichiro Kobayashi, Kanji Miyata, Shinji Fukata, Norihiro Yuasa, Yuji Hayashi, Tomoki Ebata, Hiroshi Seko, Junji Washizu

Department of Surgery, Japanese Red Cross Nagoya First Hospital

A 67-year-o1d male underwent sigmoidectomy for sigmoid colon cancer. Macroscopic examination of the resected specimen showed type 2, advanced colon cancer, 22×16 mm in diameter, SE, P₀, H₀, M (-). Histological examination disclosed poorly differentiated adenocarcinoma, se, ly₂, v₁, n₄, (+), Stage IV, Cur B. Sixteen months later, computed tomography disclosed an abnormal low density mass, 5 cm in diameter, in the right adrenal gland, suggestive of adrenal metastasis. Since no other metastases in the lung, liver or bone could be identified, right adrenalectomy was performed. Resected specimen showed hard tumor, 65×45×30 mm in diameter, with a yellowish-white and solid cut surface. Histological findings were the same as that of the sigmoid colon cancer. Thirteen months after adrenalectomy, the recurrances of paraaortic lymph nodes and bone metastases of the thoracic vertebras were revealed by abdominal computed tomography and bone scintigraphy. Although 7 months later descending colon cancer was detected and resected, he was died with postoperative pneumonia. Patients with adrenal metastasis from colon and rectal cancer often have multiple organ metastases. However, if the adrenal metastasis is solitary or the other metastatic lesions are well-controlled, the adrenal metastasis should be excised completely.

Key words
colon cancer, adrenal metastasis, adrenalectomy

Reprint requests
Toru Kawai Department of Surgery, Japanese Red Cross Nagoya First Hospital
3-35 Michishita-cho, Nakamura-ku, Nagoya, 453-0046 JAPAN

Accepted
July 22, 1998

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