OPERATIVE MANAGEMENT OF ADRENAL METASTASES FROM LUNG-CARCINOMA

Most surgeons consider patients with solitary adrenal metastasis from a primary lung carcinoma incurable and avoid excision of both the adre nal and primary lung tumors. However, several cases of successful surg ical management of these patients recently have been reported. We revi ewed 12 surgically treated patients with isolated adrenal and lung dis ease and identified 2 survivors of greater than fifteen years (17%) an d 4 additional patients who are still alive following combined resecti on (34%). This survival rate, albeit in a selected population, represe nts an improvement over the natural history of nine months' survival. We suggest that if after six to twelve months of following patients wi th lung cancer and isolated adrenal metastasis no other evidence of sp read of disease is evident, the tumor biology may be favorable and res ection of both adrenal and lung lesions is reasonable.