Second to adrenal adenomas [1], adrenal metastatic lesions are among the most common type of tumors [2]. Approximately half of the adrenal tumors resected are metastases [3,4]. Presence of metastases has been established by autopsy in 13 to 38% of the patients deceased from extra-adrenal malignant disorders, suggesting that the adrenal gland is one of the most frequent sited of metastatic dissemination [5-9]. Isolated adrenal metastases have been found in less than 1% of those cases [9]. The most common primary malignant disorders metastasizing into the adrenal glands are renal-cell carcinoma, melanoma, lung carcinoma, and colorectal carcinomas [8, 10-12]. The abundant sinusoidal blood supply of the adrenal glands and the possible communication between the pulmonary and retroperitoneal lymphatic pathways facilitate the metastatic process [8,9,13]. Management of adrenal metastases is an individualized approach and may include surgical resection, chemotherapy, local ablation, or radiotherapy [14,15]. A number of studies have confirmed increased survival rates after adrenalectomy at the absence ofprimary process dissemination in other organs [16-18]. Several analyses have been conducted in order to define survival rate prognostic factors in patients with adrenal gland metastases [19-21].