Öz
Kolorektal kanser tüm kanserler arasında ölüme neden olan ikinci sıklıktaki kanserdir. Karaciğer ve akciğer kolorektal kanserlerin ana metastaz yerleri iken adrenal metastaz klinik olarak nadirdir. Eskiden metastazlar otopsilerde saptanırken, görüntüleme ve tanısal tekniklerin gelişmesi sayesinde rutin takiplerde fark edilebilir. Adrenal metastazı olan hastalar diffüz sistemik yayılım kabul edilir ve cerrahi rezeksiyona uygun değillerdir. Bu nedenle kolorektal kanserli hastalarda izole adrenal metastaz tedavide ikilem yaratmaktadır. Bu olguda hemikolektomi ve adrenal metastazektomi uygulanan kolorektal kanserli hastada adrenal kitleyi rapor etmekteyiz. Adrenal kitle iyi huylu idi. Rezeksiyona uygun klinik soliter lezyonlar seçili hastalarda yapılabilir ve uzun süreli sağkalım sağlar. Aynı zamanda doğru tanının konmasını sağlar.
Anahtar Kelimeler
Kaynakça
- Kim SH, Brennan MF, Russo P, Burt ME, Coit DG.The role of surgery in the treatment of clinically isolated adrenal metastasis. Cancer 1998; 82: 389-94.
- Murakami S, Terakado M, Hashimoto T, Tsuji Y, Okubo K, Hirayama R. Adrenal metastasis from rectal cancer: Report of a case. Surg Today 2003; 33: 126Katayama A, Mafune K, Makuuchi M. Adrenalectomy for solitary adrenal metastasis from colorectal carcinoma. Jpn J Clin Oncol 2000; 30: 414-6.
- Adler JT, Mack E, Chen H. Equal oncologic results for laparoscopic and open resection of adrenal metastases. J Surg Res 2007; 140: 159-64.
- Nagakura S, Shirai Y, Nomura T, Hatakeyama K. Long-term survival after resection of colonic adenocarcinoma with synchronous metastases to the liver, adrenal gland, and aortic-caval lymph nodes: Report of a case. Dis Colon Rectum 2002; 45: 1679-80.
- Kanjo T, Albertini M, Weber S. Long-term disease-free survival after adrenalectomy for isolated colorectal metastases. Asian J Surg 2006; 29: 291-3. Mitchell IC, Nwariaku FE. Adrenal masses in the cancer patient: Surveillance or excision. Oncologist 2007; 12: 168-74.
- Sancho JJ, Triponez F, Montet X, Sitges-Serra A. Surgical management of adrenal metastases. Langenbecks Arch Surg 2012; 397: 179-94.
- Kosmidis C, Efthimiadis C, Anthimidis G, Levva S, Ioannidou G, Zaramboukas T, Emmanouilides C, Baka S, Kosmidou M, Basdanis G, Fachantidis E. Adrenalectomy for solitary adrenal metastasis from colorectal cancer: A case report. Cases J 2008; 1: 49.
- Bovio S, Cataldi A, Reimondo G, Sperone P, Novello S, Berruti A, Borasio P, Fava C, Dogliotti L, Scagliotti GV, Angeli A, Terzolo M. Prevalence of adrenal incidentaloma in a contemporary computerized tomography series. J Endocrinol Invest 2006; 29: 298-302.
- Hood MN, Ho VB, Smirniotopoulos JG, Szumowski J. Chemical shift: The artifact and clinical tool revisited. Radiographics 1999; 19: 357-71.
- Blake MA, Prakash P, Cronin CG. PET/CT for adrenal assessment. AJR Am J Roentgenol. 2010; 195: 91-5.
- Terzolo M, Stigliano A, Chiodini I, Loli P, Furlani L, Arnaldi G, Reimondo G, Pia A, Toscano V, Zini M, Borretta G, Papini E, Garofalo P, Allolio B, Dupas B, Mantero F, Tabarin A; Italian Association of Clinical Endocrinologists. AME position statement on adrenal incidentaloma. Eur J Endocrinol 2011; 164: 851. Gundgaard MG, Soerensen JB, Ehrnrooth E. Third-line therapy for metastatic colorectal cancer. Cancer Chemother Pharmacol 2008; 61: 1-13.
- Heniford BT, Arca MJ, Walsh RM, Gill IS. Laparoscopic adrenalectomy for cancer. Semin Surg Oncol 1999; 16: 293-306.
- Zografos GN, Markou A, Ageli C, Kopanakis N, Koutmos S, Kaltsas G, Piaditis G, Papastratis G. Laparoscopic surgery for adrenal tumors. A retrospective analysis. Hormones (Athens) 2006; 5: 52-6.
Öz
Among all cancers, colorectal cancer is the second leading cause of cancer related death. Liver and lung are known as the main metastatic sites of colorectal cancer, on the other hand the metastasis of adrenal is clinically rare. Formerly, metastases were detected at autopsy, but due to improved imaging and diagnostic techniques, many of these lesions now can be detected on routine followup imaging. Patients with adrenal metastasis are considered having systemic spread and therefore unsuitable for surgical resection. That’s why, isolated adrenal metastasis presents a therapeutic dilemma in colorectal cancer patients. In this case, we report an adrenal mass in a patient with colorectal cancer to whom rectosigmoidectomy, colectomy and adrenal metastasectomy were performed. The adrenal mass was benign. For solitary and resectable lesions adrenalectomy can be performed and prolonged survival can be achieved in selected patients. Also, this enables to achieve right histopathological diagnosis.
Anahtar Kelimeler
Kaynakça
- Kim SH, Brennan MF, Russo P, Burt ME, Coit DG.The role of surgery in the treatment of clinically isolated adrenal metastasis. Cancer 1998; 82: 389-94.
- Murakami S, Terakado M, Hashimoto T, Tsuji Y, Okubo K, Hirayama R. Adrenal metastasis from rectal cancer: Report of a case. Surg Today 2003; 33: 126Katayama A, Mafune K, Makuuchi M. Adrenalectomy for solitary adrenal metastasis from colorectal carcinoma. Jpn J Clin Oncol 2000; 30: 414-6.
- Adler JT, Mack E, Chen H. Equal oncologic results for laparoscopic and open resection of adrenal metastases. J Surg Res 2007; 140: 159-64.
- Nagakura S, Shirai Y, Nomura T, Hatakeyama K. Long-term survival after resection of colonic adenocarcinoma with synchronous metastases to the liver, adrenal gland, and aortic-caval lymph nodes: Report of a case. Dis Colon Rectum 2002; 45: 1679-80.
- Kanjo T, Albertini M, Weber S. Long-term disease-free survival after adrenalectomy for isolated colorectal metastases. Asian J Surg 2006; 29: 291-3. Mitchell IC, Nwariaku FE. Adrenal masses in the cancer patient: Surveillance or excision. Oncologist 2007; 12: 168-74.
- Sancho JJ, Triponez F, Montet X, Sitges-Serra A. Surgical management of adrenal metastases. Langenbecks Arch Surg 2012; 397: 179-94.
- Kosmidis C, Efthimiadis C, Anthimidis G, Levva S, Ioannidou G, Zaramboukas T, Emmanouilides C, Baka S, Kosmidou M, Basdanis G, Fachantidis E. Adrenalectomy for solitary adrenal metastasis from colorectal cancer: A case report. Cases J 2008; 1: 49.
- Bovio S, Cataldi A, Reimondo G, Sperone P, Novello S, Berruti A, Borasio P, Fava C, Dogliotti L, Scagliotti GV, Angeli A, Terzolo M. Prevalence of adrenal incidentaloma in a contemporary computerized tomography series. J Endocrinol Invest 2006; 29: 298-302.
- Hood MN, Ho VB, Smirniotopoulos JG, Szumowski J. Chemical shift: The artifact and clinical tool revisited. Radiographics 1999; 19: 357-71.
- Blake MA, Prakash P, Cronin CG. PET/CT for adrenal assessment. AJR Am J Roentgenol. 2010; 195: 91-5.
- Terzolo M, Stigliano A, Chiodini I, Loli P, Furlani L, Arnaldi G, Reimondo G, Pia A, Toscano V, Zini M, Borretta G, Papini E, Garofalo P, Allolio B, Dupas B, Mantero F, Tabarin A; Italian Association of Clinical Endocrinologists. AME position statement on adrenal incidentaloma. Eur J Endocrinol 2011; 164: 851. Gundgaard MG, Soerensen JB, Ehrnrooth E. Third-line therapy for metastatic colorectal cancer. Cancer Chemother Pharmacol 2008; 61: 1-13.
- Heniford BT, Arca MJ, Walsh RM, Gill IS. Laparoscopic adrenalectomy for cancer. Semin Surg Oncol 1999; 16: 293-306.
- Zografos GN, Markou A, Ageli C, Kopanakis N, Koutmos S, Kaltsas G, Piaditis G, Papastratis G. Laparoscopic surgery for adrenal tumors. A retrospective analysis. Hormones (Athens) 2006; 5: 52-6.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Bölüm | Olgu Sunumları |
| Yazarlar | |
| Yayımlanma Tarihi | 30 Aralık 2013 |
| Yayımlandığı Sayı | Yıl 2013Cilt: 35 Sayı: 4 |