Tsalis Kostas, Zacharakis Emmanouil, Sapidis Nikolaos, Lambrou Ioannis, Zacharakis Evangelos, Betsis Dimitrios
4th Surgical Department, Aristotle University of Thessaloniki, G. Papanikolaou General Regional Hospital, Exohi, Thessaloniki 57010, Greece.
World J Surg Oncol. 2005 Jul 25;3:50. doi: 10.1186/1477-7819-3-50.
Metastases from hepatocellular carcinoma (HCC) can be found in the lung and adrenal gland. We report case of a patient who presented with adrenal metastasis as the first clinical manifestation of HCC.
A patient was referred for surgical treatment for a tumor in retro-peritoneal space. The computerized tomography (CT) scan revealed a mass originating from the left adrenal gland. The patient underwent left adrenalectomy and the exploration of abdominal cavity did not reveal any other palpable lesions. Histologically, the resected lesion was a poorly differentiated metastatic tumor from HCC. Seven months later patient was readmitted complaining of cachexia, icterus, and significant weight loss. CT scan revealed hyperdense lesions of the liver.
HCC may have atypical presentations like in present case. Fine needle aspiration/tru-cut biopsy might be useful in the investigation of an accidentally discovered adrenal mass regardless of the size and can lead to the detection of a primary tumor.
肝细胞癌（HCC）转移灶可见于肺和肾上腺。我们报告一例以肾上腺转移为HCC首发临床表现的患者。
一名患者因腹膜后间隙肿瘤被转诊接受手术治疗。计算机断层扫描（CT）显示一个起源于左肾上腺的肿块。患者接受了左肾上腺切除术，腹腔探查未发现其他可触及的病变。组织学检查显示，切除的病变是来自HCC的低分化转移瘤。七个月后，患者因恶病质、黄疸和体重显著减轻再次入院。CT扫描显示肝脏有高密度病变。
HCC可能有像本病例这样的非典型表现。无论肾上腺肿块大小如何，细针穿刺抽吸/切割活检可能有助于对意外发现的肾上腺肿块进行检查，并可能导致原发性肿瘤的检测。
