[Laparoscopic surgery of adrenal gland metastasis: case report]

Laparoscopic adrenalectomy is unanimously recognised as the gold standard for the surgical treatment of adrenal lesion. Also the role of laparoscopic adrenalectomy (LA) for metastasis is controversial. This study, in according with literature dates, aimed to confirm that patients are most likely to have prolonged survival after resection of adrenal metastases and confirms that oncological outcome of laparoscopic adrenalectomy are similar with open adrenalectomy.

The study included patients who underwent LA from 2000 to 2005. Indications for LA were adrenal masses with no radiological evidence of involvement of the surrounding structure, or solitary metastases with well-controlled primary cancer. The variable evaluated were port-site and intra-addominal recurrence, distant metastasis and survival time. Primary tumors were the followings: lymphoma non-Hodgkin, lung cancer. Patients age was mean 69 (range, 62-77), the lesions were at right adrenal gland. No conversion to open surgery occurred. No complication were observed. Mean operative time was 100 minutes (range, 90-110). No postoperative complication occurred. Mean diameter of the tumor was 4.5 cm (range, 4.2-4.8 cm). Tumor free margins were obtained. Mean hospital stay was 3 day. At follow-up mean of ten months (eight-twelve months) there was any sight of distant metastases and the patient was alive.

LA seems to be a feasible option if the principles of oncological surgery are respected. Adrenalectomy for metastasis, with intent to prolong survival, should be offered to patient with favourable tumor biology, such as those with significant DFI.