Silent Synchronous Bilateral Adrenal Metastases from a Primary Renal Cell Carcinoma

Approximately one-third of renal cell carcinomas (RCC) have distant metastases at presentation, and the risk of developing a metastatic disease remains even up to 20 years after nephrectomy. Almost one-fifth of the metastases are to the adrenal glands, and one adrenal only is generally affected. Adrenal metastases remain "silent" because as little as one-tenth of healthy adrenal tissue can regulate normal body function. We report a rare case of silent, advanced, synchronous, bilateral adrenal metastases in a patient presenting with RCC.

Keywords:

• Renal Cell Carcinoma
• Adrenal Metastases
• Hematuria
• Steroid Replacement Therapy