[Adrenal involvement in renal carcinoma. Diagnostic value of computerized tomography].
We investigated the sensitivity and specificity of computed tomography (CT) in the detection of ipsilateral involvement of the adrenal glands by renal cancer. We reviewed 350 cases of radical nephrectomy for renal cancer; the adrenal gland had been removed during nephrectomy in 185 cases. Histology confirmed adrenal gland involvement from renal cancer in 9 cases, namely 4 metastatic nodules and 5 cases of direct tumor invasion. Adrenal involvement was identified by preoperative CT in 3 cases only: the gland was undetectable in 2 of them, being masked by a large tumor mass, while it appeared normal on CT images in the 4 patients with metastatic nodules. An adrenal gland appearing normal during preoperative CT assessment of renal cancer is not very likely to be involved by cancer (2.4% of cases in our series), while a gland missed at CT is very likely involved because it may be masked by a large tumor.