Ultrasound in the evaluation of adrenal metastases

Metastatic involvement of the adrenal glands is a frequent complication of bronchogenic carcinoma, occuring in up to 33% of these patients. Examination of ten patients with adrenal metastases revealed large adrenal masses, occuring bilaterally in five. Five of these patients were examined using the standard bistable technique. These patients demonstrated largely echofree masses with only occasional scattered internal echoes. The remaining five patients were examined with the gray scale technique. With the added resolution afforded by the use of gray scale, the masses in these patients showed a more uniform distribution of echoes. Presence of a margin between the kidney and the mass, and displacement of the kidney inferiorly, posteriorly, and laterally is used to differentiated between upper pole renal masses and those of adrenal origin. Autopsy confirmation was obtained in six of the patients.