Adrenal gland and paraganglia
Other adrenal malignancies

Author: Nat Pernick, M.D. (see Authors page)

Revised: 21 January 2016, last major update February 2005

Copyright: (c) 2002-2016,, Inc.

PubMed Search: Metastases [title] adrenal
Definition / General
  • Common at autopsy, usually bilateral
  • Most common primary sites are breast or lung
    • Also GI tract, melanoma, renal cell carcinoma, thyroid and contralateral adrenal gland
  • Usually does not affect adrenal function
    • May cause adrenal insufficiency if extensive (replacing 80%+ of adrenal gland)
Gross Description
  • Single or multiple firm masses replacing some or all of adrenal gland
  • Hemorrhage and necrosis in larger metastases
  • Tumors are tan-brown to black
Gross Images

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Unknown primary

Differential Diagnosis
  • Adrenocortical carcinoma: melanA+, inhibin+, calretinin+, synaptophysin+, keratin- and EMA-
    • Metastases are usually opposite