title: Two-stage operation for hepatocellular carcinoma with synchronous bilateral adrenal gland metastasis.
abstract: Hepatocellular carcinoma (HCC) frequently metastasizes to the adrenal glands. The surgical strategy for HCC associated with bilateral adrenal gland metastasis is complicated because of the possibility of both postoperative hepatic failure and adrenal insufficiency. We herein report a patient with HCC with synchronous bilateral adrenal gland metastasis that was treated successfully with a two-stage operation. A 58-year-old man with HCC (12 cm in diameter) in the right lobe of the liver and bilateral adrenal gland tumors (right, 4 cm in diameter; left, 5 cm in diameter) was admitted to our hospital. Extended right hemihepatectomy and right adrenalectomy were performed simultaneously. The postoperative course was uneventful. Three months after this operation, left adrenalectomy was performed via a retroperitoneal approach. Hydrocortisone supplement was given, and the postoperative course was again uneventful. No recurrence was observed during the 10-month follow-up period. Two-stage surgery is a safe treatment option for giant HCC with synchronous bilateral adrenal gland metastasis.
authors.affiliation: Department of Surgical Oncology and Regulation of Organ Function, Miyazaki University School of Medicine, 5200 Kihara, Kiyotake, Miyazaki 889-1692, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Kondo
authors.forename: Kazuo
authors.initials: K
authors.lastname: Chijiiwa
authors.forename: Motoaki
authors.initials: M
authors.lastname: Nagano
authors.forename: Ryoichi
authors.initials: R
authors.lastname: Hamasuna
authors.forename: Atsushi
authors.initials: A
authors.lastname: Yamashita
authors.forename: Kousuke
authors.initials: K
authors.lastname: Marutsuka
authors.forename: Nobuyasu
authors.initials: N
authors.lastname: Takahashi
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Akiyama
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000556:secondary / Q000601:surgery*; D000315:Adrenalectomy; D006528:Carcinoma, Hepatocellular / Q000556:secondary / Q000601:surgery*; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged