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目的分析肾细胞癌并发同侧肾上腺转移癌的发生率，探讨肾癌根治术作同侧肾上腺切除的可行性。方法报告５年间行肾癌根治术５６例，其中３例并发同侧肾上腺肿瘤，仅１例为肾上腺转移癌。结果３例均行同侧肾上腺切除的肾癌根治术，均痊愈出院。１例肾癌并发肾上腺转移癌者术后随访２年，健在。另２例分别为并发肾上腺皮质腺瘤及嗜铬细胞瘤，术后随访５年及２５年，健在。结论肾细胞癌并发同侧肾上腺肿瘤并不都是转移癌。肾癌根治术不必都作肾上腺切除，只有肾上极肾癌直接蔓延至肾上腺及肾上腺有转移癌时才作肾上腺切除。术前影像学检查及术中探查肾上腺正常者肾上腺可不必切除。
Objective To analyze the incidence of renal cell carcinoma complicated with ipsilateral adrenal metastasis and investigate the feasibility of ipsilateral adrenalectomy for radical nephrectomy. Methods Five cases of radical nephrectomy were performed in 56 cases, of which 3 cases were complicated with ipsilateral adrenal tumors and only 1 case was metastatic adrenal carcinoma. Results All the 3 cases underwent radical nephrectomy with ipsilateral adrenalectomy and were cured. One case of renal cell carcinoma with adrenal metastasis was followed up for 2 years. The other two cases were complicated with adrenocortical adenoma and pheochromocytoma, respectively. The patients were followed up for 5 years and 2 5 years. Conclusions Renal cell carcinoma is not metastatic to ipsilateral adrenal tumor. Radical nephrectomy is not necessary for adrenalectomy, and only renal supratentorial kidney cancer spread directly to the adrenal gland and adrenal metastasis before adrenalectomy. Preoperative imaging and intraoperative exploration adrenal normal adrenal need not be removed.