A Case of Hepatocellular Carcinoma with Long-time Survival by Successful Surgical Management of Metachronous Lung and Bilateral Adrenal Metastasis

Nozomi Minagawa, Takahito Nakagawa, Toshiya Kamiyama, Kazuaki Nakanishi, Hirofumi Kamachi, Kazuhito Uemura, Michiaki Matsushita, Tomoo Ito* and Satoru Todo

Department of Surgery I and Department of Pathology*, Hokkaido University of Medicine

We report a rare case of successful surgical management for lung and bilateral adrenal metastasis after hepatic resection for hepatocellular carcinoma. A 68-year-old man admitted with a tumor about 7.5 cm in diameter at hepatic S6/7, accidentally found in traumatic injury, underwent right hepatectomy in February 1998. In December 2000, a metastasizing lesion at S9 of the left lung was detected by chest CT, necessitating video-assisted partial left lung resection. In July 2001, a metastasizing lesion of the right adrenal gland was detected by abdominal CT and the right adrenal gland resected. In April 2002, a tumor about 22 mm in diameter at S4 of the liver was detected and treated by radio frequency ablation. In January 2004, a tumor of the left adrenal gland was detected and the left adrenal gland resected. He has survived over 6 years since the first operation, and over 2 year and 8 months since resection of the right adrenal gland. He is alive and well now with no recurrence. Hepatocellular carcinoma easily recurs and metastasizes. In the present situation with no effective chemotherapy for hepatocellular carcinoma, surgical resection of distant metastasis may contribute to long-term survival.

Key words
hepatocellular carcinoma, adrenal metastasis, surgery

Reprint requests
Nozomi Minagawa Department of Surgery I, Hokkaido University of Medicine
N14W5 Kita-ku, Sapporo, 060-8648 JAPAN

Accepted
March 30, 2005

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