Background: The adrenal gland is a common site of extrahepatic metastases from a hepatocellular carcinoma (HCC). However, treatment of adrenal metastases has not been well characterized. Methods: Of 562 patients who underwent hepatic resection for a HCC, 91 developed extrahepatic metastases. We reviewed the medical records of 10 patients with adrenal metastases (9 males and 1 female; mean age 63 years at the time of hepatic resection). Results: The mean diameter of the primary tumors was 5 cm, and all were located in the right lobe of the liver. The mean interval from hepatic resection to recurrence was 18 months. Seven patients underwent treatment of intrahepatic recurrence. To treat the adrenal metastases, surgical resection was performed in 4 patients, and transcatheter arterial embolization was performed in 1 patient. The patients treated had no other extrahepatic metastases. The mean diameter of the resected adrenal tumors was 6 cm. There was no hospital mortality. With surgical resection, 1 patient has been alive 63 months after recurrence. Conclusions: Adrenal metastases from a HCC were often large at the time of diagnosis. Since surgical resection was a safe procedure, and some patients could be alive for a long time, it should be performed whenever possible.

1.
Shuto T, Hirohashi K, Kubo S, Tanaka H, Tsukamoto T, Yamamoto T, Ikebe T, Kinoshita H: Changes and results of surgical strategies for hepatocellular carcinoma: 452 consecutive patients over 15 years. Jpn J Surg 1998;28:1124–1129.
2.
Lo CE, Lai ECS, Fan ST, Choi TK, Wong J: Resection for extrahepatic recurrence of hepatocellular carcinoma. Br J Surg 1994;81:1019–1021.
3.
Lam CM, Lo CM, Yuen WK, Liu CL, Fan ST: Prolonged survival in selected patients following surgical resection for pulmonary metastasis from hepatocellular carcinoma. Br J Surg 1998;85:1198–1200.
4.
Kuromatsu R, Hirai K, Majima Y, Fujimoto T, Shimauchi Y, Tsukiyama Y, Aoki E, Saitsu H, Nakashima O, Kojiro M, Tanikawa K: 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. Gastroenterol Jpn 1993;38:312–316.
5.
Nakashima T, Okuda K, Jojiro M, Jimi A, Yamagushi R, Sakamoto K, Ikari T: Pathology of hepatocellular carcinoma in Japan: 232 consecutive cases autopsied in ten years. Cancer 1983;51:863–877.
6.
Yamashita N, Fukawa M, Imaizumi N, Matsumoto S, Tabuchi M, Hiroyoshi M, Kitahara K, Okushima K, Noda T: Establishing a diagnosis of adrenal metastasis from hepatocellular carcinoma by 99mTc-PMT hepatobiliary scintigraphy. Jpn J Surg 1992;22:565–567.
7.
Li C, Kakizoe T, Tobisu K, Tanaka Y, Mizutani T, Makuuchi M, Okura H, Teshima S: Solitary adrenal metastasis from hepatocellular carcinoma: A report of simultaneous successful resections. Jpn J Clin Oncol 1990;20:420–425.
8.
Nakamura K, Sato Y, Nakata H: Computed tomography of adrenal metastases in hepatocellular carcinoma. Acta Radiol 1989;30:550–552.
9.
Takayasu K, Muramatsu Y, Moriyama N, Yamazaki S, Kishi E: Surgical treatment of adrenal metastasis following hepatectomy for hepatocellular carcinoma. Jpn J Clin Oncol 1989;19:62–66.
10.
Shuto T, Kinoshita H, Hirohashi K, Kubo S, Tanaka H, Tsukamoto T, Okuda T: Indication for, and effectiveness of, a second hepatic resection for recurrent hepatocellular carcinoma. Hepatogastroenterology 1996;43:932–937.
11.
Imagaki Y, Unoura M, Urabe T, Ogino H, Terasaki S, Matsushita E, Kaneko S, Morioka T, Furusawa A, Wakabayashi T, Makino H, Hattori N, Kobayashi K: Distant metastasis of hepatocellular carcinoma after successful treatment of the primary lesion. Hepatogastroenterology 1993;40:316–319.
12.
Sasaki Y, Imaoka S, Shibata T, Wada H, Nagano H, Ishikawa O, Furukawa H, Fukuda I, Kyoama H, Doi O, Iwanaga T, Ishiguro S: Successful surgical management of pulmonary and adrenal metastases from hepatocellular carcinoma. Eur J Surg Oncol 1991;17:84–90.
13.
Yoshimi F, Meigata K, Nagao T, Fukushima S, Uchida H, Wakabayashi T: Hepatocellular carcinoma with a solitary adrenal metastasis and poor hepatic functional reserve: Report of a case. Jpn J Surg 1994;24:268–271.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.