Endocrine Abstracts

Introduction: Adrenal metastases used to be rare in endocrinology compared to others adrenal tumours, and deemed to have a dire prognosis. Our aim is to analyze 13 cases in order to study their morphological aspects, their causes, and their outcome.

Subjects and method: Thirteen cases were studied over a long period of time (2000–2012). All of them had biological, hormonal, and radiological assessments.

Results: We had ten men and three women, mean=58.2 (33–72). They consulted for an aching back or abdomen (n=6), and for weight loss (n=3). The adrenal mass was discovered incidentally by ultrasounds in 3 cases, and after an adrenal crisis in one case. On CT scan they were bilateral (n=9) and unilateral (right adrenal) in 4 cases. Mean size=43.54 mm (11–100 mm). They were generally well limited (13), heterogeneous (3) and with low density (2), but much vascularised. For adrenal function, the cortisol was normal or very low, and sometimes high (error, stress, collision tumour??). Other metastases were located in bones (n=3), lymph nodes (n=2), brain (1), liver (1), pulmonary (n=1), and pituitary (n=1). They survived 7.75 months (1–24).The primary cancer was: pulmonary (n=8), pleural (n=1), thyroid (n=2), and unknown origin (3).

Conclusion: Adrenal metastases are rare (1.08/year). They prevail in males. They are associated to other metastases, but they can be discovered incidentally. They are generally large, bilateral and much vascularized. For their cause, pulmonary cancer is in the first position, but all other cancers can be the cause. Their dire prognosis can be worsened by an adrenal crisis; for this they should be recognised very soon.