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Late renal metastasis from sigmoid adenocarcinoma
Review
Laparoscopic adrenalectomy
66 Raviv G, Klein E, Yellin A, et al. Surgical treatment of solitary adrenal metastases from lung carcinoma. J Surg Oncol 1990; 43: 123–24. 67 Higashiyama M, Doi O, Kodama K, et al. Surgical treatment of adrenal metastasis following pulmonary resection for lung cancer: comparison of adrenalectomy with palliative therapy. Int Surg 1994; 79: 124–29. 68 Ayabe H, Tsuji H, Hara S, et al. Surgical management of adrenal metastasis from bronchogenic carcinoma. J Surg Oncol 1995; 58: 149–54. 69 Ettinghausen SE, Burt ME. Prospective evaluation of unilateral adrenal masses in patients with operable non-small-cell lung cancer. J Clin Oncol 1991; 9: 1462–66. 70 Porte H, Siat J, Guibert B, et al. Resection of adrenal metastases from non-small cell lung cancer: a multicenter study. Ann Thorac Surg 2001; 71: 981–85.
71 Lo CY, van Heerden JA, Soreide JA, et al. Adrenalectomy for metastatic disease to the adrenal glands. Br J Surg 1996; 83: 528–31. 72 Kim SH, Brennan MF, Russo P, et al. The role of surgery in the treatment of clinically isolated adrenal metastasis. Cancer 1998; 82: 389–94. 73 Sarela AI, Murphy I, Coit DG, Conlon KC. Metastasis to the adrenal gland: the emerging role of laparoscopic surgery. Ann Surg Oncol 2003; 10: 1191–96. 74 Chen B, Zhou M, Cappelli MC, Wolf JS Jr. Port site, retroperitoneal and intra-abdominal recurrence after laparoscopic acrenalectomy for apparently isolated metastasis. J Urol 2002; 168: 2528–29. 75 Rassweiler J, Tsivian A, Kumar AV, et al. Oncological safety of laparoscopic surgery for urological malignancy: experience with more than 1000 operations. J Urol 2003; 169: 2072–75.
Clinical picture Late renal metastasis from sigmoid adenocarcinoma Alexander Julianov, Hristo Stoyanov, and Anatoli Karashmalakov
A 63-year-old man presented with a right renal colic and haematuria. 5 years previously he had been treated with left colectomy and adjuvant chemotherapy based on fluorouracil and folinic acid for node-positive adenocarcinoma of the sigmoid colon. At admission the physical examination showed no abnormalities and the laboratory tests were unremarkable. Abdominal CT scans showed a mass in the right kidney and hydronephrosis (figure A). Subsequent urography and iodine-131-hippuran nephrography showed loss of function of the right kidney. At laparotomy, along with the tumour in the kidney,
metastases were also detected in the liver, diaphragm, and peritoneum. A nephrectomy of the right kidney was done to prevent haematuria and septic complications. The nephrectomy sample showed tumour with papillary protrusions and bleeding points within the renal pelvis (figure B). Histologically, a metastasis from the primary large-bowel adenocarcinoma was diagnosed. Systemic chemotherapy with irinotecan, fluorouracil, and folinic acid was given as palliative treatment for 6 months. 1 year after the operation the patient is alive with progressive disease but no further haematuria.
Correspondence: Dr Alexander Julianov, 235 Sveta Troica Street, 6000 Stara Zagora, Bulgaria. Tel: +359 4250814. Fax: +359 42600156. Email: [email protected]
Note to potential authors The Lancet Oncology has a large stock of Clinical pictures ready for publication. Regrettably, we cannot accept any new submissions until January, 2005.
726
Oncology Vol 5 December 2004
http://oncology.thelancet.com
Laparoscopic adrenalectomy
66 Raviv G, Klein E, Yellin A, et al. Surgical treatment of solitary adrenal metastases from lung carcinoma. J Surg Oncol 1990; 43: 123–24. 67 Higashiyama M, Doi O, Kodama K, et al. Surgical treatment of adrenal metastasis following pulmonary resection for lung cancer: comparison of adrenalectomy with palliative therapy. Int Surg 1994; 79: 124–29. 68 Ayabe H, Tsuji H, Hara S, et al. Surgical management of adrenal metastasis from bronchogenic carcinoma. J Surg Oncol 1995; 58: 149–54. 69 Ettinghausen SE, Burt ME. Prospective evaluation of unilateral adrenal masses in patients with operable non-small-cell lung cancer. J Clin Oncol 1991; 9: 1462–66. 70 Porte H, Siat J, Guibert B, et al. Resection of adrenal metastases from non-small cell lung cancer: a multicenter study. Ann Thorac Surg 2001; 71: 981–85.
71 Lo CY, van Heerden JA, Soreide JA, et al. Adrenalectomy for metastatic disease to the adrenal glands. Br J Surg 1996; 83: 528–31. 72 Kim SH, Brennan MF, Russo P, et al. The role of surgery in the treatment of clinically isolated adrenal metastasis. Cancer 1998; 82: 389–94. 73 Sarela AI, Murphy I, Coit DG, Conlon KC. Metastasis to the adrenal gland: the emerging role of laparoscopic surgery. Ann Surg Oncol 2003; 10: 1191–96. 74 Chen B, Zhou M, Cappelli MC, Wolf JS Jr. Port site, retroperitoneal and intra-abdominal recurrence after laparoscopic acrenalectomy for apparently isolated metastasis. J Urol 2002; 168: 2528–29. 75 Rassweiler J, Tsivian A, Kumar AV, et al. Oncological safety of laparoscopic surgery for urological malignancy: experience with more than 1000 operations. J Urol 2003; 169: 2072–75.
Clinical picture Late renal metastasis from sigmoid adenocarcinoma Alexander Julianov, Hristo Stoyanov, and Anatoli Karashmalakov
A 63-year-old man presented with a right renal colic and haematuria. 5 years previously he had been treated with left colectomy and adjuvant chemotherapy based on fluorouracil and folinic acid for node-positive adenocarcinoma of the sigmoid colon. At admission the physical examination showed no abnormalities and the laboratory tests were unremarkable. Abdominal CT scans showed a mass in the right kidney and hydronephrosis (figure A). Subsequent urography and iodine-131-hippuran nephrography showed loss of function of the right kidney. At laparotomy, along with the tumour in the kidney,
metastases were also detected in the liver, diaphragm, and peritoneum. A nephrectomy of the right kidney was done to prevent haematuria and septic complications. The nephrectomy sample showed tumour with papillary protrusions and bleeding points within the renal pelvis (figure B). Histologically, a metastasis from the primary large-bowel adenocarcinoma was diagnosed. Systemic chemotherapy with irinotecan, fluorouracil, and folinic acid was given as palliative treatment for 6 months. 1 year after the operation the patient is alive with progressive disease but no further haematuria.
Correspondence: Dr Alexander Julianov, 235 Sveta Troica Street, 6000 Stara Zagora, Bulgaria. Tel: +359 4250814. Fax: +359 42600156. Email: [email protected]
Note to potential authors The Lancet Oncology has a large stock of Clinical pictures ready for publication. Regrettably, we cannot accept any new submissions until January, 2005.
726
Oncology Vol 5 December 2004
http://oncology.thelancet.com