Adrenal metastases

Introduction Adrenal metastasis is common in adrenal metastases. Adrenal metastasis is the fourth most common site for tumor metastatic tumors, mostly from lung cancer, breast cancer, stomach cancer, liver cancer and pancreatic cancer. Therefore, in patients with the above primary malignant tumors, adrenal masses are also found, and adrenal metastases should be considered first. The most prominent feature of the clinical manifestations of adrenal metastatic carcinoma is that all patients with adrenal metastatic cancer have no abnormalities such as adrenal cortex and medullary hyperfunction or hypotonia, and no pain symptoms. A few have back pain, nausea and vomiting.

Cause

1. Renal tumors, especially the expansion and infiltration of suprarenal tumors.

2. Spread through the small vascular plexus between the suprarenal and adrenal glands.

3. The tumor thrombus is retrogradely spread from the renal vein or vena cava to the adrenal vein and eventually reaches the adrenal gland.

4. Systemic blood circulation of tumor cells spreads.

an examination

Related inspection

Tumor associated antigen tumor gene P53 antibody (P53-AB)

The most prominent feature of the clinical manifestations of adrenal metastatic carcinoma is that all patients with adrenal metastatic cancer have no abnormalities such as adrenal cortex and medullary hyperfunction or hypotonia, and no pain symptoms. A few have back pain, nausea and vomiting. Because adrenal metastatic cancer patients do not have special clinical manifestations, the diagnosis and treatment of adrenal metastatic cancer has certain difficulties. If it is not through surgery, especially surgery, it is difficult to conduct pathological or cytological diagnosis, and there is no specific tumor marker. The examination assists in diagnosis and can only be diagnosed by imaging (abdominal ultrasound, enhanced CT and MRI). Most of the adrenal metastasis and metastasis pathways pass through the blood or lymphatic system, and bilateral adrenal metastasis is common, and unilateral adrenal metastasis can also occur. Adrenal metastatic carcinoma can be associated with primary cancer with adrenal metastatic cancer metastasis:

(1) direct expansion and infiltration of renal tumors, especially upper renal tumors;

(2) Diffusion of small vascular plexus between the superior renal adrenal gland;

(3) The tumor thrombus is retrogradely spread from the renal vein or vena cava to the adrenal vein and finally reaches the adrenal gland;

(4) Systemic blood circulation of tumor cells.

Differential diagnosis

Differential diagnosis of adrenal metastasis:

Primary adrenal cortical adenocarcinoma: primary adrenal cortical adenocarcinoma and adrenal metastatic carcinoma are more difficult to distinguish clinically. Such metastatic cancer can be derived from lung cancer, liver cancer and kidney cancer. Immunohistochemistry was used to detect the expression of A103 and inhibin A proteins in tumor tissues. It was found that these two substances were only positively expressed in adrenal tissue, thus excluding metastatic cancer. Another method is to perform adrenal angiography with labeled cholesterol. Except for a very small number of kidney cancers, most metastatic carcinomas rarely absorb cholesterol that uses this marker, which helps to identify primary adrenal and metastatic cancer.

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