The appearance of these tumours have characteristics similar to those of solid renal tumours. MRI probably gives just as good information. Angiography is still helpful in the diagnosis of these localizations since the lower adrenal arteries are usually well demonstrated, especially on the right. The left adrenal artery is less often visualized 12 . It is therefore desirable to diagnose metastatic lesions while they are solitary and small.
Early diagnosis facilitates aggressive surgical resection.
The management of such cases is always adrenalectomy and replacement therapy with corticosteroids for life. In conclusion, contralateral solitary metastases in the adrenals, after nephrectomy for renal cancer, although rare, are asymptomatic. They do not appear with signs of adrenal insufficiency. A close follow-up of all patients who have undergone nephrectomy for renal cancer is necessary, especially for patients who are asymptomatic for many years after the primary operation. Many adrenal metastases probably have been overlooked in the past when advanced imaging techniques were not available.