Robotic-Assisted Adrenalectomy for Presumed Metastasis in a Male Patient With Breast Cancer: A Case Report

We report the case of a 57-year-old male with T1N1M0, estrogen receptor-positive (ER+), progesterone receptor-positive (PR+), and human epidermal growth factor receptor 2-negative (HER2-), corresponding to American Joint Committee on Cancer Stage IIA (AJCC Stage IIA) invasive ductal cell carcinoma of the left breast, who underwent a radical mastectomy with adjuvant chemotherapy. CT and MRI imaging demonstrated an adrenal nodule that persisted even after the patient's chemotherapy regimen was completed. Subsequent PET imaging detected a hypermetabolic left adrenal mass concerning for distant metastasis. Ultimately, the patient and care team decided that a robotic-assisted left adrenalectomy was likely the best course of action. Intraoperative frozen and final pathology both confirmed a benign adrenal fibroadenoma. This case highlights the diagnostic challenges faced when distinguishing adrenal metastasis from benign lesions in patients with a history of malignancy, especially when imaging findings are nonspecific. The case emphasized the sheer importance of multidisciplinary evaluation and potential surgical intervention in rare malignancies, such as male breast cancer, where existing guidelines are often extrapolated from female populations.