Highlights
- •The most common sites for lymph node (LN) metastases in right ACC are para-caval LN.
- •The most common sites for LN metastases in left ACC are para-aortic and renal-hilar LN.
- •Further studies are needed to define the boundaries of therapeutic lymphadenectomy.
Abstract
Background
The anatomic boundaries of lymphadenectomy for adrenocortical carcinoma (ACC) are
not defined.
Methods
Adults undergoing resection of ACC were included. Locations were categorized based
on positive LN locations on final pathology.
Results
Of 231 resected ACC, 6% had positive LN during initial resection. Positive LN in left
ACC (n = 7) were: 2 para-aortic, 2 left renal-hilar, 1 para-aortic and left renal-hilar
and 1 unknown, while for right ACC (n = 7): 2 para-caval, 1 para-caval and right renal-hilar,
1 inter-aortocaval, 1 celiac, 1 para-aortic, and 1 unknown. Of 55 resections for recurrent
ACC, positive LN in left ACC (n = 2) were: 1 para-aortic, and 1 para-aortic with left
renal-hilar, while LN for right ACC (n = 7): 2 inter-aortocaval, 2 right renal-hilar,
2 para-caval and one retrocrural.
Conclusion
The most common LN metastases are para-caval for right, and para-aortic and left renal-hilar
for left ACC. Further studies are necessary to determine the boundaries of lymphadenectomy
in ACC resection.
Keywords
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Article info
Publication history
Published online: October 19, 2021
Accepted:
October 11,
2021
Received in revised form:
September 28,
2021
Received:
May 18,
2021
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
