Introduction: Menopausal adrenal tumours may be elements of a complex panel of co-morbidities. Some of these are represented by the presence of a second pathology requiring surgery at the kidney level.
Aim: We aim to introduce a series of two cases involving menopausal women who were referred for specific endocrine assays after they had a unilateral nephrectomy (UN).
Method: This is a cases series observational study. The patients gave their consent. They were followed in different medical and surgical centres from Romania.
Results: A 61-year woman was admitted for a right adrenal and a thyroid incidentaloma after left UN for renal cancer with clear cells, Fuhrman Nuclear Grade of 2 (pT3N0Mx). Post-operatory endocrine panel of investigations were consistent for non-secretor low risk lesion. A fine needle aspiration biopsy at thyroid excluded a second malignancy. A 56-year old female had left UN 14 years ago for a benign condition. One year after surgery a right adrenal tumour of 1.2 cm was discovered at CT (computer tomography) scan. After 13 years, the subject became hypertensive and experienced hot flushes in association with secondary amenorrhea so an endocrine evaluation was considered. Non-secretor adrenal profile and high Follicle Stimulant Hormone consistent for physiological menopause was associated with stationary CT aspects for right adrenal tumor but also a left adrenal tumor of 1.3 cm was identified. Nevertheless, abdominal CT scan performed 1 year later showed similar aspects. Further serial imaging was recommended.
Discussion: Adrenal incidentaloma discovered in menopausal patients with UN requires a complex differential diagnosis including the fact that they need to be differentiated from metastases arising from kidney cancer. Also, serial imaging assessments after kidney removal may lead to the discovery of different solid masses as thyroid incidentaloma or nodules.
20 May 2017 - 23 May 2017