Why is the adrenal gland removed during a radical nephrectomy?

Updated: Feb 05, 2019
  • Author: Richard A Santucci, MD, FACS; Chief Editor: Bradley Fields Schwartz, DO, FACS  more...
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Answer

Removal of the adrenal gland has been advocated because the gland is enclosed within the Gerota fascia and because ipsilateral adrenal metastasis occurs in 2-10% of most reported series. [10] The risk of adrenal metastasis is related to the malignant potential of the primary tumor and its size and position. The need for routine ipsilateral adrenalectomy currently is under debate. A new report of 247 patients with RCC showed that only 3% of patients had adrenal involvement; each case was diagnosed preoperatively with CT scanning. [11] However, patients with large tumors or tumors high in the upper pole are probably better served with a standard radical nephrectomy that includes adrenalectomy.


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