Treatment of adrenal metastases after hepatic resection of a hepatocellular carcinoma

Background. The adrenal gland is a common site of extrahepatic metastases f rom a hepatocellular carcinoma MCC). However, treatment of adrenal metastas es has not been well characterized. Methods: Of 562 patients who underwent hepatic resection for a HCC, 91 developed extrahepatic metastases. We revie wed 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: Th e 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 recur rence was 18 months. Seven patients underwent treatment of intrahepatic rec urrence. To treat the adrenal metastases, surgical resection was performed in 4 patients, and transcatheter arterial embolization was performed in 1 p atient. The patients treated had no other extrahepatic metastases. The mean diameter of the resected adrenal tumors was 6 cm. There was no hospital mo rtality. 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 s ome patients could be alive for a long time, it should be performed wheneve r possible. Copyright (C) 2001 S. Karger AG, Basel.