Case Report Bilateral synchronous adrenal metastasis of invasive ductal carcinoma treated with multimodality therapy including adrenalectomy and oophorectomy Orhan Onder Eren 1 , Cetin Ordu 2 , Nalan A Selcuk 3 , Cengiz Akosman 4 , Mehmet Akif Ozturk 5 , Ferda O ¨ zkan 6 , O ¨ zcan Gokce 7 and Basak Oyan 1 Abstract A 38-year-old woman presented with a mass in the left breast. Biopsy of the lesion revealed invasive ductal carcinoma. Bilateral adrenal metastasis was detected in whole body positron emission tomography scanning. Needle biopsy of the left adrenal lesion proved infiltration of malignant cells from breast carcinoma. After eight cycles of neoadjuvant (preoperative) chemotherapy, mastectomy, bilateral adrenalectomy, and bilateral oopherectomy were performed. No further hormonal treatment was recommended due to the resection of both adrenal glands and ovaries. The patient is still followed without any sign of progression. To our knowledge, this is the first case representing multimodality approach to breast cancer with bilateral synchronous adrenal metastasis. Patients with oligometastatic disease may benefit from aggressive treatment including local therapies. Keywords Synchronous, adrenal metastasis, ductal carcinoma Introduction Patients with metastatic breast cancer (MBC) usually have a poor prognosis. 1 Although great progress has been made in chemotherapy, hormonal therapy and targeted therapies, cure is still impossible in most of the patients. 2,3 Less than 10% of the patients may sur- vive beyond five years, but there is increasing evidence showing that long-term survival can be achieved in a subset of patients with limited metastasis, the so-called oligometastatic disease. 4,5 Invasive ductal carcinoma is the most common histologic type of invasive breast carcinomas. The usual sites of metastasis of invasive ductal carcinoma are bones, lung, liver, and brain. 6 Adrenal gland metas- tasis due to invasive breast carcinoma is rarely encoun- tered in routine daily practice. 7,8 Synchronous bilateral adrenal metastasis due to breast carcinoma treated with metastasectomy has not been reported in English litera- ture. Most of the reported cases are from autopsy series and frequently associated with invasive lobular carcinoma of breast rather than invasive ductal carcinoma. 9–11 Herein we present a case of invasive ductal carcin- oma presenting with bilateral adrenal gland metastasis 1 Department of Medical Oncology, Faculty of Medicine, Yeditepe University, Istanbul, Turkey 2 Department of Medical Oncology, Faculty of Medicine, Bilim University, Istanbul, Turkey 3 Department of Nuclear Medicine, Faculty of Medicine, Yeditepe University, Istanbul, Turkey 4 Department of Medical Oncology, Medical Park Hospital, Ordu, Turkey 5 Department of Internal Medicine, Faculty of Medicine, Yeditepe University, Istanbul, Turkey 6 Department of Pathology, Faculty of Medicine, Yeditepe University, Istanbul, Turkey 7 Department of General Surgery, Faculty of Medicine, Yeditepe University, Istanbul, Turkey Corresponding author: Mehmet Akif Ozturk, Yeditepe University Hospital, Devlet Yolu, Ankara Caddesi, No:102–104, Istanbul, Turkey. Email: akifozturk@hotmail.com J Oncol Pharm Practice 2016, Vol. 22(1) 157–160 ! The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/1078155214551314 opp.sagepub.com