[Adrenal involvement in renal carcinoma. Diagnostic value of computerized tomography]. / Coinvolgimento surrenalico nel carcinoma renale. Valore diagnostico della Tomografia Computerizzata.

ABSTRACT

PURPOSE: We investigated the sensitivity and specificity of computed tomography (CT) in the detection of ipsilateral involvement of the adrenal glands by renal cancer. MATERIAL AND METHODS: We reviewed 350 cases of radical nephrectomy for renal cancer; the adrenal gland had been removed during nephrectomy in 185 cases. RESULTS: Histology confirmed adrenal gland involvement from renal cancer in 9 cases, namely 4 metastatic nodules and 5 cases of direct tumor invasion. Adrenal involvement was identified by preoperative CT in 3 cases only the gland was undetectable in 2 of them, being masked by a large tumor mass, while it appeared normal on CT images in the 4 patients with metastatic nodules. CONCLUSIONS: An adrenal gland appearing normal during preoperative CT assessment of renal cancer is not very likely to be involved by cancer (2.4% of cases in our series), while a gland missed at CT is very likely involved because it may be masked by a large tumor.