A Case of Left Adrenal Gland Metastatic Cancer Diagnosed by Endoscopic Ultrasound-Guided Fine Needle Aspiration

With widespread use of imaging techniques, the discovery of adrenal incidentalomas is increasing recently. Benign tumors are more frequent than malignant tumors in adrenal incidentalomas. Among malignant adrenal incidentalomas, metastatic neoplasms are the most common etiology. Traditional techniques to obtain tissue of adrenal gland include percutaneous approach under computed tomography or abdominal ultrasound guidance as well as open or laparoscopic adrenalectomies. They are invasive and associated with considerable complications such as pneumothorax, pancreatitis, adrenal abscesses, bacteremia, needle-tract metastases, and hemorrhage. Currently, endo scopic ultrasound-guided fine needle aspiration (EUS-FNA) is increasingly used to obtain tissue for diagnosis if the lesion is located in close proximity to the gut lumen. Compared with the traditional percutaneous techniques of tissue acquisition, EUS-FNA has many advantages including less invasiveness and lower complication rate. Here, we report a case of metastatic non-small cell carcinoma of left adrenal gland diagnosed by EUS-FNA with a review of literature.

Retroperitoneal Fibrosis; Diagnosed as an Aderenal Gland Orgin Tumor Preoperatively

Retroperitoneal fibrosis is a rare fibrosing reactive process, which is characterized by diffuse or localized fibroblastic proliferation and chronic lymphoplasmacytic infiltration in the retroperitoneum causing compression or obstruction of the ureters, aorta, or other vascular structures. The majority of cases are idiopathic. A 35-year old woman was transferred for further evaluation and the management of a mass in the left adrenal area. She suffered from vague abdominal pain, which was dull, non-colicky and poorly localized. She had no obstruction of the ureters or vascular structures. The preoperative diagnosis was a tumor of the left adrenal gland. A solitary retroperitoneal mass was excised, which was proven to be localized idiopathic retroperitoneal fibrosis. She was discharged on the 9th post operative day without any complications.