A Case of Resected Bilateral Adrenal and Lung Metastases Ten Years after Surgery for Colon Cancer

A 65-year-old man underwent sigmoidectomy for colon cancer in 1997. Ten years after the first operation his serum CEA level increased, and FDG-PET showed abnormal accumulation in the left adrenal gland and the right lung. Abdominal and chest CT scan demonstrated a tumor in the same lesion of the adrenal gland and the lung. From these findings, adrenal and lung metastasis of colon cancer was suspected, therefore a partial resection of the upper lobe of the right lung was performed for diagnostic purposes. Pathological diagnosis of the tumor revealed metastatic adenocarcinoma of colon cancer. Then left adrenalectomy was performed successfully. Pathological findings again showed metastatic adrenal tumor of colon cancer. Serum CEA levels decreased gradually after the operation. However, 5 months after the surgery, FDG-PET disclosed abnormal accumulation only in the right adrenal gland, whereupon right adrenalectomy was performed additionally. In Japan, only 37 cases with resection of adrenal metastasis from colorectal cancer have been reported, probably because of non-resectability, and only 3 with bilateral adrenalectomy have been reported. We report a patient with colon cancer who had bilateral adrenal and lung metastases 10 years after the first operation, and review the relevamt literature.