Right adrenal metastases of hepatocarcinoma after liver transplantation: case report and literature review

Transplant Proc. 2009 Apr;41(3):1067-9. doi: 10.1016/j.transproceed.2009.02.018.

Abstract

Background: Hepatocellular carcinoma (HCC) represents one of the most common malignancies globally, accounting for nearly one million new cases per year. Although the treatment of extrahepatic metastases from primary liver tumors is essentially palliative, a solitary metastasis from such tumors offers a possibility of cure by surgical resection. The adrenal gland is an uncommon site for metastasis from primary liver tumors.

Methods: We report a liver transplantation case of HCC and hepatitis B virus in a 23-year-old man with an excellent postoperative result. However, because an increased alpha-fetoprotein was evident and complete radiologic and blood tests were performed, all of which were normal. Three years posttransplantation, a right adrenal mass was identified by CT. PAAF was performed as well as adrenalectomy for a solitary adrenal metastasis from hepatocellular carcinoma.

Results: The patient underwent adrenalectomy for the right adrenal metastasis at 3 years following liver transplantation for HCC. He is presently alive and disease-free 24 months after adrenalectomy.

Conclusion: Carefully selected patients with solitary metastasis from HCC may be considered for resection.

Publication types

  • Case Reports

MeSH terms

  • Adrenal Gland Neoplasms / diagnostic imaging
  • Adrenal Gland Neoplasms / secondary*
  • Adrenal Gland Neoplasms / surgery*
  • Adrenalectomy*
  • Adult
  • Carcinoma, Hepatocellular / mortality
  • Carcinoma, Hepatocellular / pathology*
  • Carcinoma, Hepatocellular / surgery*
  • Everolimus
  • Follow-Up Studies
  • Humans
  • Immunosuppressive Agents
  • Liver Neoplasms / immunology
  • Liver Neoplasms / pathology*
  • Liver Neoplasms / surgery*
  • Liver Transplantation / adverse effects*
  • Liver Transplantation / mortality
  • Liver Transplantation / pathology*
  • Neoplasm Metastasis
  • Sirolimus / analogs & derivatives
  • Sirolimus / therapeutic use
  • Survival Analysis
  • Time Factors
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Young Adult

Substances

  • Immunosuppressive Agents
  • Everolimus
  • Sirolimus