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Adrenalectomy for Bilateral Metachronous Adrenal Recurrence of Hepatocellular Carcinoma After Liver Transplant: A Case Report
Ist Teil von
Experimental and clinical transplantation, 2020-06, Vol.18 (3), p.407-409
Ort / Verlag
Başkent Üniversitesi
Erscheinungsjahr
2020
Link zum Volltext
Quelle
EZB Free E-Journals
Beschreibungen/Notizen
Hepatocellular carcinoma is the fifth most common
cancer in the world and the third leading cause of
cancer-related death. It is currently one of the leading
indications for liver transplant, with selected 5-year
survival rates after liver transplant of about 70%.
Despite excellent results of liver transplant for
hepatocellular carcinoma, a number of patients develop
metastases after transplant, and multifocal metastatic
disease is the most frequent cause of death. In a
large autopsy series of patients with hepatocellular
carcinoma, adrenal glands were the third most common
site of extrahepatic metastasis after lungs and bones.
However, isolated metastatic disease in the adrenal
glands is rare, and isolated metachronous bilateral
metastasis is an even rarer occurrence. Only few reports
have been published of metachronous bilateral metastasis of hepatocellular carinoma after liver
transplant treated with bilateral adrenalectomy. We
describe a case of a 56-year-old man who underwent
liver transplant for hepatocellular carcinoma in a
cirrhotic liver. Two years after liver tranplant,
regular follow-up revealed metastatic disease in the
left adrenal gland. Preoperative imaging showed no
other metastasis, and he underwent an uneventful
left adrenalectomy. A year after surgery, he presented
with right flank pain and tenderness. Imaging showed
hemorrhage and tumor involvement of the right
adrenal gland, and he underwent right adrenalectomy.
Two years after surgery, he is alive and well
with no signs of disease recurrence. Apparently, in the
absence of intrahepatic or other metastases, bilateral metachronous recurrence of hepatocellular carcinoma
after liver tranplant can be a good surgical indication
with acceptable long-term survival.