Abstract
This paper presents a case treated with one-stage bilateral thoracotomy for bilateral pulmonary metastases from the adrenal gland carcinoma. In 1976, when the patient was 46 years old, she suffered from Cushing's syndrome due to the left adrenal gland carcinoma associated with bilateral multiple pulmonary metastatic foci. Op′-Dichloro-diphenyl-dichloroethane was administered and the adrenal gland was extirpated. The pulmonary metastatic foci vanished.
A coin lesion was noticed on the left upper lung field of a chest X-ray film taken in May 1980 but there were no symptoms. However, productive cough and chest pain were encountered 7 months later and another lesion in the right lower lung field was observed. In April 1981 she was admitted to our department for surgery.
On operation, right posterolateral thoracotomy was performed at first and the tumor, weighing 25g, was resected from the S8 area and the chest was closed. Then left thorax was entered by means of a posterolateral incision and a 2.5g tumor in S2 was excised by wedge resection. Histological examination showed the characteristics of adrenal carcinomas in both tumors. The postoperative course of this patient was uneventful. The one-stage bilateral thoracotomy diminished the lung function, but it was enough to ensure a satisfactory quality of daily life.
It should be emphasized that in those patients whose pulmonary metastatic lesions grow slowly and are sensitive to chemotherapeutic agents, one-stage bilateral thoracotomy and tumor excision may be recommended.
