Adrenal Metastases:

Most common cancer metastasizing to the adrenals:
- Lung ca
- RCC
- melanoma
- breast ca
- gastrointestinal ca
- HCC
- lymphoma

Work-up:
- patients with a solitary adrenal mass and symptoms suggestive of malignancy should have screening colonoscopy, mammography and CXR to try and identify the primary tumor
- PET scan may be helpful to identify the primary disease
- FNA can be performed: but only after a pheo has been ruled out

Presence of a solitary met - may benefit from adrenalectomy
- usually small and contained within capsule.
- lap adrenalectomy has been shown to have an equally effective outcome as open adrenalectomy
- 5 year survival 25%