Adrenal metastasis from hepatocellular carcinoma (HCC): Report of 3 cases

Although autopsy reports show that the adrenal gland is the second most com mon organ of hematogeneous metastasis from hepatocellular carcinoma (HCC), paradoxically there is found to be a very scarce number of the adrenal meta stasis in clinical practice. We have recently experienced rare patients wit h right adrenal metastasis from HCC. Case 1: A 51 year-old man with a 5-yea r history of chronic hepatitis was admitted with hematemesis to Nippon Medi cal School Hospital. CT revealed a main tumor associated with a few daughte r tumors in the hepatic posterior segment and in addition another tumor loc ated between the right hepatic lobe and right kidney. The diagnosis of HCC with a right adrenal gland metastasis was made, and hepatectomy and right a drenalectomy was performed. Twenty months after operation he was alive and free of disease. Case 2: A 78 year-old man underwent resection of the later al segment of the left hepatic lobe for HCC. Twelve months later, recurrent foci in the residual liver were found and those were treated with transart erial embolization (TAE). Right adrenal metastasis was found on CT 26 month s after hepatectomy. TAE was done for the hepatic recurrent tumors and adre nal metastasis. Twelve months after, he survived in good condition. Case 3: A 47 year-old man presented with liver cirrhosis with a long history. He w as diagnosed as having HCC with multiple intrahepatic metastases and was tr eated with TAE 4 times. Follow-up CT revealed right adrenal metastasis. TAE was done for hepatic recurrent tumor and right adrenal metastasis. Three m onths later the patient died of liver failure.