Background: Surgery remains the only effective treatment for renal carcinoma. According the current surgical procedure, both the neoplastic kidney with its perirenal tissue and the Gerota fascia with adrenal gland must be removed. In the last years, the utility of routine adrenalectomy for kidney cancer surgery has been questioned and some authors now recommend this procedure just in selected cases.
Methods: In order to provide a contribution to this debate, 350 cases of nephrectomy after renal carcinoma have been reviewed. In all, 185 adrenalectomy have been performed and neoplastic involvement of adrenal gland has been identified just in 9 cases (4.9%), suggesting a rarity of tumor progression to adrenal gland at the time of surgery.
Results: Moreover, neoplastic involvement of adrenal gland has been shown in just 3 cases at preoperatively CT scan.
Conclusions: The conclusion is drawn that adrenal gland may be retained in surgery for radical nephrectomy after renal carcinoma. Adrenalectomy may be recommended in doubtful cases, especially in upper pole localization and in large tumours.
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