Page 24 - Delaware Medical Journal - October 2017
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FIGURE 3
Diagnosis of adrenal metastasis can be made by CT-guided FNA biopsy with immunohistochemical stains on cell block material, as in this case. (A.) H&E stained cell block material showing irregular clusters of malignant tumor cells. (B.) Positive GATA3 immunostaining is consistent with breast origin of this carcinoma. (C.) An immunostain for Cytokeratin 7 is also positive in this case, as was an immunostain for estrogen receptor (ER), (D.)
FIGURE 4
steroid replacement therapy and clinically improved. Bilateral adrenalectomy was attempted but unsuccessful given the tumor size and extension outside of
the adrenals. The patient was started
on Fulvestrant via clinical trial along with steroid replacement therapy which continues through April 2017. On last CT scan of chest/abdomen/pelvis in 2010 she had no progression of disease and PET scan revealed resolution of adrenal activity. (Figure 5) As of October 2016 the patient remains asymptomatic and without any clinical evidence of disease progression.
DISCUSSION
from disseminated metastatic cancer
is common; however metastasis
is an uncommon cause of adrenal two cases with isolated adrenal metastases and primary adrenal long intervals from the time of primary diagnosis to metastasis. KY Lam’s study in 2002 found that of 464 patients with adrenal metastasis the detection
of adrenal metastasis occurred shortly
Patient #2 CT abdomen and Pelvis showing bilateral adrenal enlargement in 2005 (diagnosis of metastatic disease).
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Del Med J | October 2017 | Vol. 89 | No. 10
