title: [Resection of Adrenal Metastasis after Chemotherapy and Radiation Therapy for a Patient with Stage IV B Hepatocellular Carcinoma].
abstract: In the treatment of hepatocellular carcinoma, atypical, off guideline multidisciplinary approaches are sometimes effective. A 70-year-old man was diagnosed with multiple hepatocellular carcinomas, multiple bone metastases, and a right adrenal metastasis. Sunitinib was started and the primary hepatic lesions and bone metastases disappeared. However, his adrenal metastasis worsened. Sorafenib, radiotherapy, and some investigational agents were administered, but the adrenal metastasis did not respond. There were no other new lesions except the adrenal lesion 4 years after the initial treatment, so we decided to perform a resection. In the left half lateral decubitus position, the adrenal mass was removed with right thoracolaparotomy. After the surgery, his tumor markers quickly returned to normal. Seven years after the initial treatment(2 years and 4 months after the last surgery), he is alive without any recurrence. Multidisciplinary treatment with chemotherapy, radiotherapy, and surgery may result in long term survival even for patients with advanced hepatocellular carcinoma with multiple extra-hepatic lesions.
authors.affiliation: Dept. of Surgery, Tokyo Metropolitan Bokutoh Hospital.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kanomata
authors.forename: Yasuji
authors.initials: Y
authors.lastname: Seyama
authors.forename: Hiroki
authors.initials: H
authors.lastname: Kudo
authors.forename: Atsumi
authors.initials: A
authors.lastname: Tamura
authors.forename: Yuzo
authors.initials: Y
authors.lastname: Toyama
authors.forename: Gen
authors.initials: G
authors.lastname: Kimura
authors.forename: Tooru
authors.initials: T
authors.lastname: Tanizawa
authors.forename: Masahiro
authors.initials: M
authors.lastname: Warabi
authors.forename: Masamichi
authors.initials: M
authors.lastname: Takahashi
authors.forename: Yujiro
authors.initials: Y
authors.lastname: Matsuoka
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Kondo
authors.forename: Yukio
authors.initials: Y
authors.lastname: Miyamoto
authors.forename: Nobutaka
authors.initials: N
authors.lastname: Umekita
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary / Q000628:therapy*; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000556:secondary / Q000628:therapy*; D003131:Combined Modality Therapy; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D008297:Male; D009367:Neoplasm Staging; D014057:Tomography, X-Ray Computed