title: Successful surgical management of pulmonary and adrenal metastases from hepatocellular carcinoma.
abstract: This article reports a rare case of successful surgery for both lung and adrenal metastases after hepatic resection of hepatocellular carcinoma (HCC). A 55-year-old Japanese man with a 5-year history of chronic liver disease was admitted with an elevated serum alpha-fetoprotein (AFP) value and a liver tumour detected by ultrasonography. Hepatic angiogram showed a tumour stain with the right hepatic vein as a venous drain from the tumour. He underwent posterior-inferior subsegmentectomy of the right hepatic lobe following preoperative chemoembolization. Sixteen months after the first operation, he received pulmonary resection for a solitary metastasis in the right lung. A further 10 months later, a metastatic tumour was detected in the left adrenal gland without any recurrent or metastatic foci, and he underwent left adrenalectomy as his third operation. He is still alive, 8 months after his last operation, and 34 months after hepatic resection, with a normal value of AFP and without any recurrent or metastatic foci. This may be the first report of a patient who underwent successful surgery for pulmonary and adrenal metastases of HCC.
authors.affiliation: Department of Surgery, Centre for Adult Diseases, Osaka, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Sasaki
authors.forename: S
authors.initials: S
authors.lastname: Imaoka
authors.forename: T
authors.initials: T
authors.lastname: Shibata
authors.forename: H
authors.initials: H
authors.lastname: Wada
authors.forename: H
authors.initials: H
authors.lastname: Nagano
authors.forename: O
authors.initials: O
authors.lastname: Ishikawa
authors.forename: H
authors.initials: H
authors.lastname: Furukawa
authors.forename: I
authors.initials: I
authors.lastname: Fukuda
authors.forename: H
authors.initials: H
authors.lastname: Kyoama
authors.forename: O
authors.initials: O
authors.lastname: Doi
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000556:secondary / Q000601:surgery*; D000315:Adrenalectomy; D006528:Carcinoma, Hepatocellular / Q000556:secondary / Q000601:surgery* / Q000628:therapy; D003131:Combined Modality Therapy; D004621:Embolization, Therapeutic; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery*; D008175:Lung Neoplasms / Q000556:secondary / Q000601:surgery* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy