Endocrinological evaluation demonstrated normal serum and urinary levels of aldosterone, cortisol and 17-hydroxysteroids. Laboratory tests revealed no abnormalities. A chest x-ray, chest CT scan, and bone scan were all negative for metastases. A contrast-enhanced abdominal computed tomography (CT) confirmed the presence of a 6 cm × 5 cm × 4 cm solid mass at the upper and mid pole of the right kidney with heterogeneous and enhanced areas and bilateral involvement of the adrenal glands ( Figure 1). The patient’s blood pressure and the pulse rate were normal. A physical examination revealed a mild tenderness in her right flank. Because of these findings she was admitted for further evaluation. The ultrasonography revealed a right upper pole renal mass and bilateral adrenal masses. Due to the persistence of pain despite the administration of the specific medication she was submitted to sonography. The pain initially was attributed to spondylolisthesis and she was prescribed a relative medication. The gradual deterioration of pain in the last month before her admission caused her to seek medical attention. The patient had a medical history of spondylolisthesis, osteoporosis, hypertension and hyperlipidemia. Other symptoms, including hematuria, were not present.

In this article, we report a case of right-sided RCC with simultaneous bilateral adrenal metastases, the treatment and prognosis are also discussed.Ī 58-year-old Caucasian-Greek woman presented with a dull pain located in the right flank for 4 years. Adrenal metastases from RCC are either synchronous or metachronous. Synchronous bilateral involvement was found to be present at about one fifth of all adrenal metastases.

The incidence of adrenal metastases from RCC is 6-29% in autopsy series, and one third of this incidence (2-10%) from clinical diagnosis. The most common metastatic sites from RCC are the lung, lymph nodes, liver, bone, contralateral kidney and ipsilateral adrenal gland. Due to the insidious clinical course of many primary RCCs, approximately a third of all patients have metastases at the initial diagnosis.

Renal cell carcinoma (RCC) can metastasize extensively and to unusual sites. It is well established that the incidence of adrenal metastases in certain types of malignancy, such as carcinomas of the breast, lung and melanoma is high.

Adrenal tumor on kidney