Bilateral adrenal metastases from hepatocellular carcinoma after liver transplantation.
Therapeutic management of hepatocellular carcinoma is a controversial issue. Orthotopic liver transplantation is an alternative for the treatment of hepatocellular carcinoma in a selected group of patients, but recurrence is possible. A 51-year-old patient with liver transplantation due to hepatocellular carcinoma presented bilateral adrenal metastases in a successive manner. A left adrenal gland metastasis was diagnosed five months after liver transplantation, and a left adrenalectomy was carried out. Eight months later, a right adrenal gland metastasis was diagnosed, and a right adrenalectomy was performed. Pathological examination confirmed the diagnosis of a well-differentiated hepatocellular carcinoma. At present, there is no evidence of recurrence 35 months after the second adrenalectomy. Bilateral adrenal gland metastases from hepatocellular carcinoma after liver transplantation have not been previously reported in English literature. Surgical resection of metastases may be indicated in similar patients with successful treatment of the primary tumor, absence of additional metastasic disease, and good performance status.
Castroagudín
Javier F
JF
Liver Transplantation Unit, Hospital Clínico Universitario de Santiago Santiago de Compostela, Spain. fernandezc@medynet.com
González-Quintela
Arturo
A
Martínez
Jorge
J
Tomé
Santiago
S
Forteza
Jerónimo
J
Varo
Evaristo
E
D000310:Adrenal Gland Neoplasms / Q000556:secondary*; D000315:Adrenalectomy / Q000379:methods; D006528:Carcinoma, Hepatocellular / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology* / Q000601:surgery; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome