An unusual case of adrenocortical carcinoma with liver metastasis that occurred at 23 years after surgery.
Adrenocortical carcinoma (ACC) is an uncommon and aggressive cancer occurring more frequently in women; local or distant recurrences occur in 80% of cases, typically within 1 year after curative resection. Liver is the preferred metastatic site. Herein, we report the case of a unique liver metastasis from ACC occurring 23 years after the curative prior tumor surgery. A 45-year-old woman was operated in 1991 for adrenocortical stage II without microvascular involvement or capsular infiltration. At that time, no adjuvant treatment was indicated. The initial surgery consisted on a left adrenalectomy with contemporaneous left nephrectomy and regional lymphadenectomy. Five years after surgery, the patient was considered cured. However, 23 years later, the patient presented an atypical right subcostal pain. A 4 cm liver ACC metastasis involving the segment 4 and initially diagnosed as a hemangioma was discovered. A curative resection of the segment 4 was performed. Final pathological examination confirmed the diagnosis of ACC metastasis with a complete R0 resection; no lymph node metastases were observed. This case is the latest metachronous ACC metastasis ever reported in literature. To date, the patient is alive with no signs of recurrence after a post-surgical follow-up of 13 months.
1 Hepatobiliary and Digestive Surgery Unit, CHU Rennes, France ; 2 University Rennes 1, Rennes, F-35033, France ; 3 Imaging Department, CHU Rennes, France ; 4 Pathology Unit, CHU Rennes, France.
Damien
D
Bergeat
1 Hepatobiliary and Digestive Surgery Unit, CHU Rennes, France ; 2 University Rennes 1, Rennes, F-35033, France ; 3 Imaging Department, CHU Rennes, France ; 4 Pathology Unit, CHU Rennes, France.
Michel
M
Rayar
1 Hepatobiliary and Digestive Surgery Unit, CHU Rennes, France ; 2 University Rennes 1, Rennes, F-35033, France ; 3 Imaging Department, CHU Rennes, France ; 4 Pathology Unit, CHU Rennes, France.
Luc
L
Beuzit
1 Hepatobiliary and Digestive Surgery Unit, CHU Rennes, France ; 2 University Rennes 1, Rennes, F-35033, France ; 3 Imaging Department, CHU Rennes, France ; 4 Pathology Unit, CHU Rennes, France.
Giovanni Battista
GB
Levi Sandri
1 Hepatobiliary and Digestive Surgery Unit, CHU Rennes, France ; 2 University Rennes 1, Rennes, F-35033, France ; 3 Imaging Department, CHU Rennes, France ; 4 Pathology Unit, CHU Rennes, France.
Julien
J
Dagher
1 Hepatobiliary and Digestive Surgery Unit, CHU Rennes, France ; 2 University Rennes 1, Rennes, F-35033, France ; 3 Imaging Department, CHU Rennes, France ; 4 Pathology Unit, CHU Rennes, France.
Aude
A
Merdrignac
1 Hepatobiliary and Digestive Surgery Unit, CHU Rennes, France ; 2 University Rennes 1, Rennes, F-35033, France ; 3 Imaging Department, CHU Rennes, France ; 4 Pathology Unit, CHU Rennes, France.
Laetitia
L
Tanguy
1 Hepatobiliary and Digestive Surgery Unit, CHU Rennes, France ; 2 University Rennes 1, Rennes, F-35033, France ; 3 Imaging Department, CHU Rennes, France ; 4 Pathology Unit, CHU Rennes, France.
Karim
K
Boudjema
1 Hepatobiliary and Digestive Surgery Unit, CHU Rennes, France ; 2 University Rennes 1, Rennes, F-35033, France ; 3 Imaging Department, CHU Rennes, France ; 4 Pathology Unit, CHU Rennes, France.
Laurent
L
Sulpice
1 Hepatobiliary and Digestive Surgery Unit, CHU Rennes, France ; 2 University Rennes 1, Rennes, F-35033, France ; 3 Imaging Department, CHU Rennes, France ; 4 Pathology Unit, CHU Rennes, France.
Bernard
B
Meunier
Adrenocortical carcinoma (ACC); liver metastasis; liver resection