CT demonstration and guided aspiration of unusual adrenal metastases

Certain malignant neoplasms commonly metastasize to the adrenal glands, whereas others do so only infrequently. In the latter circumstance, an adrenal mass is likely to be benign. We report 3 patients with malignant neoplasms (hepatoma, transitional cell carcinoma of the bladder, and squamous cell carcinoma of the vulva) that do not commonly metastasize to the adrenals in whom computed tomographic (CT) demonstration and guided aspiration of adrenal masses significantly affected patient management. CT guided aspiration of adrenal masses is safe and accurate and is recommended whenever a diagnosis of adrenal metastasis would alter the staging or therapy of the primary neoplasm.