A resected case of metastatic isolated adrenal tumor from lung cancer invading chest wall, which was detected 5 years previously at lung resection

A 48-year-old man was admitted due to an abnormal chest shadow, accompanied by left adrenal tumor. Chest x-ray and chest CT revealed a peripheral large mass shadow in the right upper lobe invading the chest wall. Right-upper lobectomy combined chest-wall resection was performed, and pathological examination confirmed poorly differentiated adenocarcinoma (p-T3N0M1, Stage IV). Postoperatively, value of serum CEA decreased, but then gradually increased and four years 10 months later, the left-adrenal tumor showed necrotic change with high CEA value, and Laparoscopic It adrenalectomy was performed. The tumor was 5×3.5×2 cm in size and was similar to the previous lung cancer histologically, so it was diagnosed as metastatic adenocarcinoma. This case suggests that synchronism between lung cancer and solitary adrenal metastasis does not necessarily represent an unfavorable prognostic factor. In selected cases, resecton of metastatic adrenal tumor can obtain long-term survival.