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Adrenal and other solitary metastases: when one spot is removed | CION Cancer Clinics
Surgery for a solitary adrenal metastasis removes a single secondary tumour from one adrenal gland, the small glands above the kidneys. It is sometimes considered when a cancer such as lung, kidney or bowel has spread to that one place only. The same thinking applies to a few other single spots. This page explains the tests, what the team weighs and who surgery does not suit. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
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Medically reviewed by Dr. Muralidhar MuddusettyConsultant Surgical Oncologist · MBBS (AIIMS), MS (Surgery, AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh) · last reviewed September 2026, next review due September 2027
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On this page
- Can a single spot in the adrenal gland be removed?
- Where else might a single secondary be removed?
- What tests come before adrenal surgery?
- Who is this surgery not right for?
- What do the words on the report mean?
- What do families often believe about a single secondary?
- What can this page not tell you, and what should you ask?
- Common questions about solitary metastasis surgery
The short answer
Can a single spot in the adrenal gland be removed?
Sometimes, yes. When scans show cancer has spread to one adrenal gland and nowhere else, and the original cancer is under control, removing that gland is one option a team may discuss. Focused radiotherapy and ablation are the others.
What the adrenal glands are
You have two adrenal glands, one sitting on top of each kidney. They make hormones that help control blood pressure, salt balance and the body's response to stress. You can live normally with one, because the other takes over.
Why spread often shows up there
The adrenal glands have a rich blood supply, and cancer cells travelling in the blood can settle there. Lung cancer is the most frequent source. Kidney cancer, bowel cancer and melanoma skin cancer can also spread there. A metastasis, or secondary tumour, in the adrenal gland is still made of cells from the original cancer.
Many adrenal lumps found on scans are harmless growths. Not every lump in someone with cancer is a secondary.Beyond the adrenal gland
Where else might a single secondary be removed?
The same idea applies in a few other places: one spot, nothing elsewhere, and the original cancer under control.
A group of lymph nodes
A single group of lymph nodes, the small glands that filter body fluid, far from the original cancer is sometimes removed. It is weighed carefully, because node spread often means spread elsewhere too.
The ovary
Bowel and stomach cancers occasionally spread to the ovaries. Removing them can ease symptoms and help planning, often alongside other surgery in the abdomen.
Pancreas and other organs
Kidney cancer can spread, sometimes years later, to single places such as the pancreas or thyroid. These spots are sometimes removed when nothing else is found.
Skin and soft tissue
A single secondary under the skin or in muscle, often from melanoma or kidney cancer, can usually be removed with a smaller operation.
Spleen and small bowel
Rarely, a single spot here is removed, often because it is bleeding or blocking the bowel rather than as a planned cancer operation.
Not sure whether this applies to you?
Ask an oncologistBefore surgery
What tests come before adrenal surgery?
Hormone tests
Blood and urine tests check whether the lump makes hormones. A hormone-making lump can cause dangerous blood pressure surges if handled without preparation.
Detailed scans
A CT or MRI shows the size and look of the lump. A PET-CT checks for spread anywhere else, because surgery only makes sense if this is the only spot.
Biopsy, sometimes
If it is unclear what the lump is, a needle biopsy may be done, but only after hormone tests. Sometimes the scans are clear enough that the removed gland itself gives the diagnosis.
Team review and the operation
Surgeons, oncologists and radiologists agree the plan. Adrenal removal is often keyhole; large lumps may need open surgery. Ask your centre which approach they would use.
Being straight with you
Who is this surgery not right for?
Removing a single secondary is a judgement, not a rule. The team is asking whether taking out this one spot is likely to change the course of the illness, or only add an operation to an already hard time.
What makes surgery more likely to be discussed
A long gap between the first cancer and this spot. A cancer type known to spread to one place at a time, such as kidney cancer. Good control of the original cancer. Scans that show nothing anywhere else. And enough fitness to recover well. No one of these decides it on its own.
When it usually does not help
Surgery is less likely to be recommended if the spot appeared soon after the first diagnosis, if more spots are likely to follow, or if the original cancer is still growing. For some cancers, a period of treatment with medicines comes first, to see whether new spots appear before anyone operates. Focused radiotherapy or ablation may do a similar job without a cut, especially for people less fit for surgery.
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On your report
What do the words on the report mean?
- Adrenalectomy
- Removal of an adrenal gland.
- Incidentaloma
- An adrenal lump found by chance on a scan done for something else. Most are harmless.
- Oligometastatic
- Cancer that has spread to only a few places.
- Solitary metastasis
- A single secondary tumour, with no other spread found on scans.
- Disease-free interval
- The time between treating the first cancer and finding the secondary. A longer gap is one thing teams consider.
- Functioning lump
- A lump that is making hormones. It needs preparation before any biopsy or surgery.
Commonly believed
What do families often believe about a single secondary?
"If there is only one spot, removing it ends the cancer."
Removing a single spot can sometimes lead to a long period without visible cancer. But cells too small to see may remain, and new spots can appear. That is why scans continue. No team can promise how it will go.
"Every lump on the adrenal gland is cancer."
Most adrenal lumps found on scans are harmless. Even in someone with cancer, the lump needs scans and hormone tests before anyone decides what it is.
"Losing an adrenal gland means hormone tablets for life."
Not usually. The other gland normally takes over. Lifelong replacement is needed only if both glands are removed or the remaining one is not working well.
"Radiotherapy is only for people who cannot have surgery."
Focused radiotherapy is a treatment in its own right for some single secondaries, and for certain spots it may be the preferred choice. Surgery and radiotherapy each have situations where they fit better. Ask your team why they have suggested one over the other.
Before you decide
What can this page not tell you, and what should you ask?
This page cannot tell you whether a single secondary should be removed in your family member's case, or how things will turn out. That depends on the cancer type, how it has behaved over time, the scans and the person's own health and wishes.
Questions worth writing down
Is this definitely the only spot, and which scans showed that? Has the lump been tested for hormones? Would focused radiotherapy or ablation be reasonable? Should we wait and rescan before deciding? What happens to other cancer treatment during recovery?
A second opinion is reasonable
Removing a single secondary is a less common decision, and specialists sometimes differ. Asking another team to review the scans is a normal step, not a sign of distrust. Bring every earlier report and scan disc, including the ones from the first diagnosis.
Questions we are asked
Common questions about solitary metastasis surgery
Is an adrenal secondary the same as adrenal cancer?
No. Adrenal cancer starts in the adrenal gland itself and is rare. A secondary started elsewhere, such as the lung or kidney, and spread there. They are treated very differently. The biopsy or the removed gland, examined under a microscope, tells which one it is.
Will removing one adrenal gland affect blood pressure or energy?
Usually not for long, because the remaining gland takes over. Some people feel tired for a while, and hormone levels may be checked afterwards. If the lump was making hormones, blood pressure medicines may need adjusting by your doctors.
Is keyhole adrenal surgery always possible?
Not always. Keyhole surgery suits many smaller lumps. A large lump, or one growing into the kidney or liver, may need an open operation. Your surgeon will explain the plan and whether a switch to open surgery might happen during the operation.
What are the risks of removing an adrenal gland?
Bleeding, infection, injury to nearby organs such as the spleen or pancreas, blood clots and hormone changes are the ones surgeons usually discuss. Ask how often these occur in their unit and what would be done if one happened.
Why did the doctor suggest waiting and rescanning first?
A short wait, often with medicines continuing, shows whether other spots appear. If they do, removing one spot would not have helped, and an operation has been avoided. If nothing new appears, the case for surgery is stronger. It is a common and reasonable approach.
Could radiotherapy be used instead of surgery?
For many single secondaries, focused radiotherapy is a real option. It avoids an operation but gives no tissue for testing. The choice depends on the spot's size and position, fitness and cancer type. Ask for both a surgical and a radiotherapy view.
Will more treatment be needed after the operation?
Often, yes. Chemotherapy, targeted drugs, immunotherapy or hormone treatment may continue or start after recovery, depending on the original cancer. Scans continue too. Your medical oncologist will explain the plan once the pathology report is back.
Is this surgery covered by Aarogyasri or insurance?
Cancer surgery is often covered under Aarogyasri, CGHS, ECHS, EHS and many cashless insurance policies, subject to approvals and package limits. Call the helpline with your card or policy details and your own cover can be checked.
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Sources
- National Cancer Institute — Metastatic cancer: when cancer spreads
- Cancer Research UK — About cancer
- American Cancer Society — Kidney cancer
- Macmillan Cancer Support — Cancer information and support
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Oligometastatic disease explainedWhat limited spread meansWho is a candidate for metastasectomy?What teams look at before operating on spread cancerSurgery vs SBRT for a single secondaryHow an operation and focused radiotherapy are weighedPET-CT scan guideThe scan used to check nothing else has spreadMetastasectomy and oligometastatic surgeryEvery page in this guide
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