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


CONCLUSIONS
Carefully selected patients with solitary metastasis from HCC may be considered for resection.
Unidad de Trasplante Hepático, Hospital Universitario, Puerta de Hierro, UAM, Madrid, Spain. ruge73@hotmail.com
E
E
Rubio
J
J
González
M
M
Jimenéz
J L
JL
Lucena
L
L
Gimenez
F
F
Martinez Arrieta
V
V
Cuervas-Mons
V S
VS
Turrión
D000310:Adrenal Gland Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary* / Q000601:surgery*; D000315:Adrenalectomy; D000328:Adult; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D000068338:Everolimus; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents; D008113:Liver Neoplasms / Q000276:immunology / Q000473:pathology* / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects* / Q000401:mortality / Q000473:pathology*; D009362:Neoplasm Metastasis; D020123:Sirolimus / Q000031:analogs & derivatives / Q000627:therapeutic use; D016019:Survival Analysis; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult
D007166:Immunosuppressive Agents; D000068338:Everolimus; D020123:Sirolimus