Metastatic adrenal tumor originating from lung cancer diagnosed by endoscopic ultrasound-guided fine-needle aspiration

A 75-year-old man with lung and bilateral adrenal tumors was referred to our hospital. Although the patient was suspected of having adrenal metastasis from lung cancer, the pathologic diagnosis was not confirmed by transbronchial lung biopsy (TBLB). He then underwent endoscopic ultrasound-guided aspiration (EUS-FNA) of the left adrenal tumor. From the stomach, a swollen left adrenal lesion could be visualized, and EUS-FNA was successfully performed. Histopathology results showed squamous cell carcinoma, consistent with metastasis from lung cancer. We concluded that EUS-FNA for adrenal lesions was a useful alternative approach for cases in which obtaining the histologic diagnosis from the primary tumor was not feasible. Before the procedure, it is necessary to exclude cases of pheochromocytoma and paraganglioma, because these tumors may cause hypertensive crisis.