Adrenal Metastases
Adrenal metastases are cancerous tumors that spread to the adrenal glands from cancers originating elsewhere in the body. Because the adrenal glands receive a rich blood supply, they are a common site for metastatic disease, especially from lung cancer, melanoma, kidney cancer, breast cancer, and gastrointestinal cancers. Many individuals have no symptoms, and adrenal metastases are often discovered incidentally during imaging for staging or follow-up.
What is it?
Adrenal metastases occur when cancer cells travel through the bloodstream or lymphatic system and implant in one or both adrenal glands. These metastatic tumors can vary in size and may present as a single mass or multiple lesions. While many are asymptomatic, bilateral adrenal metastases can impair adrenal gland function and lead to adrenal insufficiency, which requires prompt treatment.
Imaging helps determine size, number, and appearance of adrenal lesions as well as whether they are affecting surrounding structures. CT, MRI, and PET/CT can help distinguish metastases from benign adrenal adenomas, although biopsy may be needed when imaging features are inconclusive or when determining treatment strategy.
Important to Know
Adrenal metastases indicate that cancer has spread, which affects staging and treatment planning. Some metastases remain stable over time, while others may grow or cause symptoms depending on the primary cancer. Identifying whether a lesion is metastatic versus benign is essential for guiding management.
Red flag symptoms include severe fatigue, low blood pressure, dizziness, abdominal or flank pain, darkening of the skin, or electrolyte abnormalities—possible signs of adrenal insufficiency. Sudden worsening symptoms or rapid tumor growth may require urgent evaluation. Follow-up imaging is usually recommended to monitor treatment response or detect new lesions.