Two Resectable Cases of Adrenal Metastasis from Hepatocellular Carcinoma

Hiroaki Nagano, Yo Sasaki, Shingi Imaoka, Osamu Ishikawa, Hiroaki Ohigashi, Hiroshi Furukawa, Takeshi Iwanaga

Department of Surgery, The Center for Adult Diseases, Osaka

We experienced two cases of surgical treatment of left adrenal metastasis from hepatocellular carcinoma (HCC) after hepatectomy. The first patient was a 65-year-old man who underwent hepatectomy for advanced HCC. Recurrent foci in the residual liver were controlled by transcatheter arterial chemoembolization (TAE) therapy. As left adrenal metastasis was found by computed tomography (CT) 20 months after hepatectomy, left adrenalectomy was performed. This patient died of gastrointestinal bleeding without recurrence 13 months after adrenalectomy. The second patient was a 64-year-old man who underwent hepatectomy for HCC and partial resection of the right lung for metastatic foci. Because left adrenal metastasis was detected by CT and a high level of serum alpha fetoprotein was found, left adrenalectomy was performed. This patient survived for 7 months after adrenalectomy with no sign of recurrent HCC, but he died of recurrence in the residuallung 15 months after adrenalectomy. From our cases and other reports, it is suggested that the surgical extirpation of metastatic adrenal tumor from HCC can be effective, when the primary lesion is well-controlled and no other metastatic foci were detected.

Key words
metastatic adrenal tumor, hepatocellular carcinoma, adrenalectomy

Reprint requests
Hiroaki Nagano Department of Surgery II, Osaka University Medical School
2-2 Yamadaoka, Suita, 565 JAPAN

Accepted
January 12, 1994

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