腎細胞癌會轉移至任何器官，常見的有肺、淋巴結、肝和骨骼。轉移至腎上腺在臨床上並不常見，多半是解剖上的發現(autopsy finding)，而術前的診斷也不容易。我們回溯91例因腎細胞癌而切除腎臟的病人，發現有4例合併腎上腺轉移(4.4%)，在第一期病人中，41位接受根除性腎術(含腎上腺切除)，另10位則未切除腎上腺。這兩組病人其累積存活並未有顯著差異(p=0.646)。顯示根除性腎切除術時，腎上腺是否切除對於存活並沒有顯著差異。另外第二期病人13位均接受根除性腎切除術(含腎上腺切除)，其累積存活與第一期的41位病人亦無顯著差異(p=0.449)。腎癌單一轉移至腎上腺並不多見，在4例有腎上腺轉移的病人中，有一例被認為是單一轉移，然而病人在56個月後仍產生肺及骨骼轉移。對侷限性的腎細胞癌，例行切除腎上腺或許會有治療的機會，特別是腎上腺單一轉移的病人。但是這種腎上腺單一轉移的情形實在非常少見。另外即使是下端的腎細胞癌也有可能轉移至腎上腺。

Renal cell carcinoma is known to metastasize to every organ. The most often in volved sites are the lung, lymph nodes, liver and bone. Adrenal metastasis of renal cell carcinoma usually is an autopsy finding and seldom a clinical diagnosis. Preoperative diagnosis of adrenal involvement is not so easy as described. Retrospective examination of 91 nephrectomies for renal cell carcinoma found 4 cases of adrenal metastases (4.4 per cnet). In Stage I, the difference of cumulative survival between those undergoing radical nephrectomy (41 cases) and those spared adrenalectomy (10 cases) is insignificant (P=0.646). The cumulative survicval of Stages I and II (13 cases) undergoing radical nephrectomies also showed no difference (p=0.449). There is no significant survival difference when leaving the adrenal gland in situ while performing radical nephrectomy. For localized renal cell carcinoma, routine removal of the adrenal gland may provide a chance for cure, especially for patients with solitary adrenal metastasis. But solitary adrenal metastasis of renal cell carcinoma is very rare. One the other hand, “solitary” may turn out to be “multiple” in due course. One of the four cases of adrenal metastases was presumed to be solitary, but lung and bone metastases developed 56 months later. Besides, even lower pole renal lesions can metastasize to the adrenal gland.