Metachronous Adrenal Metastasis from Breast Invasive Ductal Carcinoma: A Case Report & Review of Literature

Breast cancer remains the most prevalent cancer among women worldwide, despite advancements in screening programs, international awareness campaigns, and various treatment options tailored to individual patient conditions.Unfortunately, breast cancer continues to be the leading cause of death among females globally.While only a quarter of patients experience distant metastases, this aspect is a significant burden of the disease, typically peaking around two years after surgery.The most common sites of distant metastasis are the bones, followed by the liver, lungs, and brain.However, it is exceedingly rare for breast cancer to metastasize to the adrenal glands, with only a few reported cases in the literature.In this report, we present an exceptionally rare case of right adrenal metastasis in 2019, originating from left invasive ductal carcinoma that had been treated with skin-sparing left breast mastectomy in 2014.The patient underwent laparoscopic right adrenalectomy.During post-adrenalectomy annual follow-up, while receiving chemotherapy and hormonal therapy, a computed tomography (CT) scan in 2023 revealed a suspicious left adrenal nodule.A percutaneous biopsy confirmed the origin of the nodule as metastatic breast cancer.To the best of our knowledge, there have been no reported cases of delayed distant recurrence manifesting as ipsilateral adrenal metastasis four years after right adrenalectomy for left breast invasive ductal carcinoma.