Solitary Adrenal Metastasis after Resection of Cancer of the Ascending Colon and Metachronous Liver Metastases. Case Report

Yasuhisa Oida, Masaya Mukai, Yuuichi Okamoto, Sayuri Mukouyama, Isao Ito, Hisao Nakazaki, Tomoo Tajima^* and Hiroyasu Makuuchi^*

Department of Surgery, Tokai University Oiso Hospital, Department of Surgery, Tokai University School of Medicine^*

A 60-year-old woman diagnosed in August 1998 with cancer of the ascending colon underwent right hemicolectomy. Histopathological findings showed well-differentiated adenocarcinoma, mp, ly₂, v₀, n₁, H₀, P₀, stage II. Twenty months postoperatively, metastases were discovered in liver segments S₆ and S₈, necessitating partial hepatectomy. During ultrasound (US) examination 18 months after the second operation, a 40-mm adrenal tumor found contacting the upper pole of the right kindney rapidly increased in size, was suspected of being metastasis to the right adrenal gland, and was excised. Histopathological examination showed highly differentiated adenocarcinoma similar to the primary focus, and since no other metastases or signs of recurrence were observed, we made a diagnosis of solitary adrenal metastasis. The postoperative course was favorable, and the patient was discharged on postoperative day 14. At present, 6 months postoperatively, the patient is being followed up as an outpatient clinic with no signs of recurrence. Only 19 cases of solitary adrenal gland metastasis colorectal cancer, including our case, have, to our knowledge, been reported in Japan. Since surgical invasion is minor and long-term survival is seen, surgery should be selected as an aggressive and positive treatment.

Key words
colorectal cancer, solitary adrenal metastasis, adrenalectomy

Reprint requests
Yasuhisa Oida Department of Surgery, Tokai University Oiso Hospital 21-1 Oiso-cho, Naka-gun, Kanagawa, 259-0198 JAPAN

Accepted
July 24, 2002

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