Four cases of colorectal cancer with solitary adrenal gland tumor

Four cases of colorectal cancer with solitary adrenal grand tumor were retrospectively studied as to whether or not preoperative differential diagnosis between metastatic and benign condition is possible. The mean age of the patients was 54.8 years old, and the male to female ratio was 1 to 1. Three cases had rectal cancer and one sigmoid colon cancer. All adrenal tumors were found by computed tomography (CT) of the abdomen. One tumor was located in the left adrenal grand, and the others on the right side. Two tumors were found preoperatively, the others postoperatively. The maximum diameter of tumors were three to four centimeters. Magnetic resonance imaging (MRI) of the abdomen was performed in two cases, and angiography in one case. The level of serum CEA was within the normal range in all cases, but that of serum CA19-9 was out of the normal range in two cases. Endocrinary function test revealed that all tumor were nonfunctional. Adrenalectomy was performed in all eases in suspicious metastatic adrenal tumor. Histopathological examinations showed that three of the tumors were adenomas, and one metastatic adenocarcinoma. It was considered to be difficult to distinguish adenoma from metastatic tumor by preoperative findings.