Pandey Durgatosh, Tan Kai-Chah
Department of Surgical Oncology, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, India.
Hepatobiliary Pancreat Dis Int. 2008 Aug;7(4):440-2.
Although the treatment of extrahepatic metastases from primary liver tumors is essentially palliative, solitary metastasis from such tumors offers a possibility of cure by surgical resection. The adrenal gland is an uncommon site for metastasis from primary liver tumors.
We report two cases of adrenalectomy for solitary adrenal metastasis: one from intrahepatic cholangiocarcinoma and the other from hepatocellular carcinoma.
The patient with intrahepatic cholangiocarcinoma had a synchronous adrenal metastasis and underwent simultaneous liver resection and adrenalectomy. However, he developed recurrent disease 17 months following surgery for which he is presently on palliative chemotherapy. The other patient underwent adrenalectomy for adrenal metastasis 3 months following liver transplantation for hepatocellular carcinoma. He is presently alive and disease-free 27 months after adrenalectomy.
Carefully selected patients with solitary metastasis from primary liver tumors may be considered for resection.
尽管原发性肝癌肝外转移的治疗本质上是姑息性的,但此类肿瘤的孤立性转移通过手术切除有治愈的可能。肾上腺是原发性肝癌转移的少见部位。
我们报告两例因孤立性肾上腺转移而行肾上腺切除术的病例:一例来自肝内胆管癌,另一例来自肝细胞癌。
肝内胆管癌患者存在同步肾上腺转移,接受了同期肝切除和肾上腺切除术。然而,他在术后17个月出现疾病复发,目前正在接受姑息化疗。另一例患者在肝细胞癌肝移植术后3个月因肾上腺转移接受了肾上腺切除术。肾上腺切除术后27个月,他目前仍存活且无疾病。
经过仔细挑选的原发性肝癌孤立性转移患者可考虑行切除术。