A 59-year-old male with a history of hypertension, chronic obstructive pulmonary disease (exsmoker), type I obesity (BMI 30.5 kg/m2) and dyslipidemia.
The patient was operated on for lung cancer and a right bilobectomy was performed. The pathology reported a poorly differentiated squamous cell carcinoma (PT2N1M0).
After remaining disease-free for 10 months, a left adrenal tumor was diagnosed by abdominal CT. FNA confirmed that it was a metastasis.
A laparoscopic approach was performed, with decreased splenic flexure of the colon and medial mobilisation of the pancreas.
When the adrenal gland is exposed, a tumoral mass in the renal artery and vein is observed, so it becomes open surgery performing a block exeresis of the kidney and the left adrenal gland.
The definitive diagnosis was left adrenal metastasis from a poorly differentiated squamous cell carcinoma and vascular involvement of the renal artery and vein, with a normal renal parenchyma.
After surgery the patient remains asymptomatic, with a disease-free interval currently of 15 months.
