| Summary: | Introduction The prognosis of adrenal metastasis from non‐small cell lung cancer is very poor. A recent report described the efficacy of the surgical removal of adrenal metastasis when solitary. However, metachronous bilateral adrenal metastasis is extremely rare, and a treatment strategy has not been established. Case presentation Herein, we describe a 52‐year‐old Asian male who presented with a right adrenal metastasis of non‐small cell lung cancer 8 months after immunochemotherapy and surgical resection of the lung. He underwent combined systemic treatment and a laparoscopic right adrenalectomy; however, after 9 months, a metachronous left adrenal metastasis emerged. A subsequent laparoscopic left adrenalectomy and systemic treatment led to long‐term progression‐free survival. Conclusion The appropriate surgical indication and combined systemic treatment of a metachronous bilateral adrenal metastasis in non‐small cell lung cancer may extend the prognosis.
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