LAPAROSCOPIC ADRENALECTOMY FOR SOLITARY METACHRONOUS CONTRALATERAL ADRENAL METASTASIS FROM RENAL-CELL CARCINOMA

Purpose: We report our experience with laparoscopic adrenalectomy for malignant adrenal disease. Materials and Methods: Between June 1995 an d January 1996, 2 patients with a solitary metachronous contralateral adrenal metastasis from renal cell cancer were evaluated. Both patient s had undergone radical nephrectomy for localized renal cancer 5 years previously, Laparoscopic transperitoneal adrenalectomy was performed. Results: The laparoscopic procedures required 2.5 and 4.3 hours. Hosp ital stay was 3 and 4 days. The specimens weighed 98 and 81 gm. All su rgical margins were free of metastatic clear cell cancer. Both patient s were begun on prednisone and fludrocortisone replacement therapy. On e patient experienced an increase in creatinine, which has since stabi lized at 3.0 mg./dl. Neither patient had recurrent cancer at 11 and 16 months of followup. Conclusions: Laparoscopic adrenalectomy for metas tatic renal cell cancer was performed successfully in 2 patients. Howe ver, the short-term benefits to the patient of earlier ambulation, dec reased pain, minimal incisions and shortened convalescence must be wei ghed against the as yet unknown long-term (5 years) results.