Adrenal metastasis of gastric carcinoma: a case report and review of the literature

Adrenal metastasis from gastric cancer (GC) is uncommon and may present synchronously with the primary tumor. The clinical characteristics and optimal management of patients with adrenal metastasis remain unclear. We report two cases of GC with synchronous adrenal metastasis. Case 1 involved a 43-year-old Han Chinese male with left adrenal metastasis who received neoadjuvant chemotherapy with docetaxel, oxaliplatin, and fluorouracil, followed by gastric cancer resection, left adrenalectomy, and jejunostomy. Histopathology showed poorly differentiated, diffuse-type adenocarcinoma (ypT3N0M1). After adjuvant ZELOX chemotherapy, the patient developed peritoneal carcinomatosis and died 737 days (24.2 months) after the initial diagnosis. Case 2 involved a 68-year-old Han Chinese male with synchronous metastases to the adrenal gland and spleen (T4bN0M1). He underwent gastric cancer resection and biopsy of an abdominal wall nodule, which revealed moderately differentiated adenocarcinoma with angiolymphatic and perineural invasion. The patient received FOLFOX chemotherapy and survived for 12 months after treatment. GC with adrenal metastasis may have a heterogeneous clinical course. Treatment should be individualized according to metastatic extent and tumor characteristics.