Surgical treatment of adrenal metastases from hepatocellular carcinoma

Czech version

Authors: J. Pudil ¹; F. Bělina ¹; K. Hlavová ²
Authors‘ workplace: Chirurgická klinika 2. LF UK a ÚVN Praha ¹; Interní klinika 1. LF UK a ÚVN Praha ²
Published in: Gastroent Hepatol 2013; 67(2): 115-117
Category: Hepatology: Case Report

Overview

Introduction:
The hepatocellular carcinoma (HCC) is the most common primary tumour of the liver. Radical resection or transplantation remains the sole curable method. The authors present an unusual case report of HCC metastasis.

Case report:
A 60-year-old man with chronic hepatitis C was indicated for liver resection due to a solitary HCC tumour. Significant elevations of AFP were observed four months after the operation, with the check-up CT showing a metastatic process in both adrenals. We performed bilateral adrenalectomy. Histological findings confirmed HCC metastasis.

Discussion:
The adrenal is the usual place of haematogenous HCC metastasis; however, it is rarely observed in clinical practice. Bilateral adrenalectomy due to adrenal metastases is only described as case reports in Asian literature. The method of choice in both unilateral and bilateral adrenalectomies is the mini-invasive approach.

Conclusion:
HCC is a disease that has been showing increasing incidence; nevertheless, bilateral adrenalectomy due to HCC metastases is rather a rare procedure. This case report shows clearly the key role of careful dispensary, launched soon after the operation.

Key words:
hepatocellular carcinoma – extrahepatic metastasis – bilateral adrenalectomy

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