Routine Adrenalectomy Is Unnecessary During Surgery for Large and/or Upper Pole Renal Tumors When the Adrenal Gland Is Radiographically Normal

Synchronous ipsilateral adrenal involvement with renal cell carcinoma is rare even in cases of large and/or upper pole tumors, making routine adrenalectomy unnecessary. Preoperative adrenal imaging is highly sensitive and should inform the decision to perform adrenalectomy more than tumor size or site.