A patient with hepatocellular carcinoma who underwent resection of the primary lesion 10 years ago and resection of a giant adrenal metastasis 8 and a half years later |
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Authors: | Ryoko Kuromatsu MD Kenji Hirai Yasuo Majima Takafumi Fujimoto Yoshihiro Shimauchi Yumi Tsukiyama Eizaburo Aoki Hideki Saitsu Osamu Nakashima Masamichi Kojiro Kyuichi Tanikawa |
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Institution: | Ryoko Kuromatsu, Kenji Hirai, Yasuo Majima, Takafumi Fujimoto, Yoshihiro Shimauchi, Yumi Tsukiyama, Eizaburo Aoki, Hideki Saitsu, Osamu Nakashima and Masamichi Kojiro, et al. |
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Abstract: | A 56-year-old male consulted us because of a palpable mass and pain of the left flank 8 and a half years after resection of
hepatocellular carcinoma of the left lobe about 3 cm in diameter. Ultrasound examination of the abdomen demonstrated a tumor
about 10 cm in diameter showing a mosaic of hyperechoic and hypoechoic areas on the upper pole of the left kidney. By angiography,
the tumor was found to be supplied mainly by the inferior adrenal artery. PIVKA-II was increased. Adrenal metastasis of hepatocellular
carcinoma was suspected, and adrenalectomy was carried out. No intrahepatic metastasis was noted. The tumor was histopathologically
identified as a pseudo-glandular type of moderately differentiated hepatocellular carcinoma with a trabecular pattern similar
to the primary lesion. In this patient, a resectable giant metastasis was observed only in the left adrenal gland and no intrahepatic
metastasis was demonstrated 8 and a half years after resection of hepatocellular carcinoma. The patient has survived 10 years
after the first operation. This case is considered to be important for evaluation of the treatment for distant metastasis
of hepatocellular carcinoma. |
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Keywords: | hepatocellular carcinoma adrenal metastasis PIVKA-II hepatéctomy |
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