Complete resection of rectal cancer with a synchronous solitary adrenal metastasis: A case report. (2020)

• Record Type: Journal Article
• Authors: Hayashi, Hirokatsu; Murase, Yusuke; Sano, Hitoya; Nishio, Kimitosi; Kumazawa, Iwao
• Is Part Of: International journal of surgery case reports. Volume 75(2020)
• Page Start: 242
• Page End: 245
• Publication Date: 2020
• Subjects: CT computed tomography -- PET-CT positron emission tomography–computed tomography -- PR partial response; Colorectal cancer -- Adrenal metastasis -- Complete resection; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; Surgery; Electronic journals; Periodicals; 617.005
• DOI: 10.1016/j.ijscr.2020.09.094
• Languages: English
• ISSNs: 2210-2612

Abstract

Highlights: Adrenal metastasis is usually associated with systemic spread of the disease and is considered to be unsuitable for surgical resection. Adrenalectomy should be considered in patients who can undergo complete resection. Adrenalectomy may offer a better long-term prognosis. Abstract: Introduction: Solitary adrenal metastasis derived from colorectal cancer is rare. Adrenal metastasis is usually associated with systemic spread of the disease and is considered to be unsuitable for surgical resection. However, it has been reported that an aggressive surgical resection of adrenal metastasis results in improved overall survival in selected patients. We herein report an extremely rare case of complete resection of rectal cancer with a synchronous solitary adrenal metastasis. Presentation of case: A 70-year-old woman who presented with bloody stool was diagnosed with rectal cancer with a synchronous solitary adrenal metastasis and was suspected of having liver invasion. After a total of 2 cycles of chemotherapy with capecitabine and oxaliplatin, an abdominoperineal resection with D2 (proxD3) lymph node dissection and right adrenalectomy was performed and complete resection was possible. According to the TNM classification, the diagnosis was stage IVA (fT3N1bM1a[ADR]). At 18 months after surgery, the patient is alive with no evidence of recurrence and distant metastasis. Discussion: Complete resection of adrenal metastasis may have a possibility of leading to a good prognosis in patients with a synchronous solitary adrenal metastasis. Conclusion: Adrenalectomy should be considered in patients who can undergo complete resection, as it may offer a good long-term prognosis.