Solitary adrenal metastasis presenting 15 years after breast cancer: a case report.

Introduction and importance: Adrenal metastasis from breast cancer is exceptionally rare and typically arises within a few years of the primary diagnosis. We report a unique case of solitary adrenal metastasis presenting 15 years after breast carcinoma, with hypercalcemia as the only symptom. Presentation of Case: A 67-year-old woman with a history of estrogen receptor/progesterone receptor positive breast adenocarcinoma diagnosed 15 years earlier presented with hypercalcemia. Imaging revealed a solitary left adrenal mass with no evidence of other metastases. She underwent an open left adrenalectomy. Histopathology confirmed metastatic breast carcinoma. Postoperatively, serum calcium normalized, and recovery was uneventful. Clinical Discussion: Solitary adrenal metastasis from breast cancer is rare, particularly after a decade-long latency. In carefully selected patients, surgical resection can provide symptom relief and may offer survival benefit. Conclusion: This case highlights that isolated adrenal metastasis can occur even after prolonged remission, with hypercalcemia as the sole presenting feature. It emphasizes the need for long-term surveillance in breast cancer survivors and the potential role of surgery in managing isolated adrenal metastases.