Adrenal metastasis
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Adrenal metastases are the most common malignant lesions involving the adrenal gland. Metastases are usually bilateral but may also be unilateral. When unilateral involvement is thought to be more common on the left side (ratio of 1.5:1) 4.
Epidemiology
They are thought to be present in up to 27% of patients with known malignant epithelial tumours at autopsy.
Pathology
Primary sites
There are many primary tumours that can potentially metastasise to the adrenal glands. Common primary tumours that metastasise to the adrenal glands include:
Other reported primary tumours include:
Radiographic features
CT
Adrenal metastases can have a variable CT appearances 4. Usually demonstrates less than 50% washout.
In patients with renal cell carcinoma and hepatocellular carcinoma who undergo dedicated adrenal CT imaging for known adrenal lesions, the percentage enhancement washout of adrenal metastases can be similar to that of lipid-poor adrenal adenomas
MRI
Exact signal characteristics can vary dependant on the type of tumour. In general, commonly described signal characteristics include:
- T1: usually exhibit low signal intensity 2
- T2: usually exhibit high signal intensity 2
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T1 C+
(Gad(Gd): usually has progressive enhancement after administration of contrast material 2
An important diagnostic feature is the lack of signal loss on out-of-phase images (in contradistinction to that seen with adrenal adenoma).
See also
-</ul><p>Other reported primary tumours include</p><ul>- +</ul><p>Other reported primary tumours include:</p><ul>
-<strong>T1 C+ (Gad):</strong> usually has progressive enhancement after administration of contrast material <sup>2</sup>- +<strong>T1 C+ (Gd):</strong> usually has progressive enhancement after administration of contrast material <sup>2</sup>
References changed:
- 1. Mayo-Smith W, Boland G, Noto R, Lee M. State-Of-The-Art Adrenal Imaging. Radiographics. 2001;21(4):995-1012. <a href="https://doi.org/10.1148/radiographics.21.4.g01jl21995">doi:10.1148/radiographics.21.4.g01jl21995</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/11452074">Pubmed</a>
- 2. Elsayes K, Mukundan G, Narra V et al. Adrenal Masses: MR Imaging Features with Pathologic Correlation. Radiographics. 2004;24 Suppl 1(suppl_1):S73-86. <a href="https://doi.org/10.1148/rg.24si045514">doi:10.1148/rg.24si045514</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/15486251">Pubmed</a>
- 3. Taniai N, Egami K, Wada M, Tajiri T, Onda M. Adrenal Metastasis from Hepatocellular Carcinoma (HCC): Report of 3 Cases. Hepatogastroenterology. 1999;46(28):2523-8. - <a href="https://www.ncbi.nlm.nih.gov/pubmed/10522032">Pubmed</a>
- 5. Choi Y, Kim C, Park B, Kim B. Evaluation of Adrenal Metastases from Renal Cell Carcinoma and Hepatocellular Carcinoma: Use of Delayed Contrast-Enhanced CT. Radiology. 2013;266(2):514-20. <a href="https://doi.org/10.1148/radiol.12120110">doi:10.1148/radiol.12120110</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/23151828">Pubmed</a>
- 6. Blake MA, Cronin CG, Boland GW. Adrenal imaging. AJR Am J Roentgenol. 2010;194 (6): 1450-60. <a href="http://dx.doi.org/10.2214/AJR.10.4547">doi:10.2214/AJR.10.4547</a> - <a href="http://www.ncbi.nlm.nih.gov/pubmed/20489083">Pubmed citation</a><span class="ref_v3"></span>
- 4. Johnson P, Horton K, Fishman E. Adrenal Mass Imaging with Multidetector CT: Pathologic Conditions, Pearls, and Pitfalls. Radiographics. 2009;29(5):1333-51. <a href="https://doi.org/10.1148/rg.295095027">doi:10.1148/rg.295095027</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/19755599">Pubmed</a>
- 1- Mayo-Smith WW, Boland GW, Noto RB et-al. State-of-the-art adrenal imaging. Radiographics. 2001;21 (4): 995-1012. <a href="http://radiographics.rsna.org/content/21/4/995.full">Radiographics (full text)</a> - <a href="http://www.ncbi.nlm.nih.gov/pubmed/11452074">Pubmed citation</a><span class="ref_v3"></span>
- 2- Elsayes KM, Mukundan G, Narra VR et-al. Adrenal masses: mr imaging features with pathologic correlation. Radiographics. 2004;24 Suppl 1 (suppl 1): S73-86. <a href="http://radiographics.rsna.org/content/24/suppl_1/S73.full">Radiographics (full text)</a> - <a href="http://dx.doi.org/10.1148/rg.24si045514">doi:10.1148/rg.24si045514</a> - <a href="http://www.ncbi.nlm.nih.gov/pubmed/15486251">Pubmed citation</a><span class="ref_v3"></span>
- 3- Taniai N, Egami K, Wada M et-al. Adrenal metastasis from hepatocellular carcinoma (HCC): report of 3 cases. Hepatogastroenterology. 1999;46 (28): 2523-8. <a href="http://www.ncbi.nlm.nih.gov/pubmed/10522032">Pubmed citation</a><span class="ref_v3"></span>
- 5- Choi YA, Kim CK, Park BK et-al. Evaluation of adrenal metastases from renal cell carcinoma and hepatocellular carcinoma: use of delayed contrast-enhanced CT. Radiology. 2013;266 (2): 514-20. <a href="http://radiology.rsna.org/content/266/2/514.full">Radiology (full text)</a> - <a href="http://dx.doi.org/10.1148/radiol.12120110">doi:10.1148/radiol.12120110</a> - <a href="http://www.ncbi.nlm.nih.gov/pubmed/23151828">Pubmed citation</a><span class="ref_v3"></span>
- 6- Blake MA, Cronin CG, Boland GW. Adrenal imaging. AJR Am J Roentgenol. 2010;194 (6): 1450-60. <a href="http://dx.doi.org/10.2214/AJR.10.4547">doi:10.2214/AJR.10.4547</a> - <a href="http://www.ncbi.nlm.nih.gov/pubmed/20489083">Pubmed citation</a><span class="ref_v3"></span>
- 4- Johnson PT, Horton KM, Fishman EK. Adrenal mass imaging with multidetector CT: pathologic conditions, pearls, and pitfalls. Radiographics. 2009;29 (5): 1333-51. <a href="http://radiographics.rsna.org/content/29/5/1333.full">Radiographics (full text)</a> - <a href="http://dx.doi.org/10.1148/rg.295095027">doi:10.1148/rg.295095027</a> - <a href="http://www.ncbi.nlm.nih.gov/pubmed/19755599">Pubmed citation</a><span class="ref_v3"></span>
Images Changes:
Image 3 CT (C+ portal venous phase) ( update )
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Case 1 -: from small cell lung cancer
Image 9 CT (C+ portal venous phase) ( create )
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