Takayasu K, Muramatsu Y, Moriyama N, Yamazaki S, Kishi K
Department of Diagnostic Radiology, National Cancer Center Hospital, Tokyo.
Jpn J Clin Oncol. 1989 Mar;19(1):62-6.
In three patients who underwent hepatectomy for solitary hepatocellular carcinoma (HCC), adrenal metastases, on the right sides of two patients and the left side of the third were subsequently detected by ultrasonography (US) and/or computed tomography (CT), and successfully resected after an average interval of 16 months from hepatectomy. There were no metastatic lesions in the lung, lymph node or bone. Two patients, however, who were found to have metastasis in the right adrenal also had multiple small recurrent foci in the residual liver. The latter were controlled by arterial embolization therapy and the patients are alive at 12 and three months post-adrenalectomy. In the other patient, with left adrenal metastasis, the serum alphafetoprotein level of 3,000 ng/ml returned to normal and he is doing well three and a half years after adrenalectomy. Since there is no effective therapy for metastatic adrenal HCC after hepatectomy, surgery would appear to be indicated, should no other distant metastasis be recognized clinically.
在3例因孤立性肝细胞癌（HCC）接受肝切除术的患者中，通过超声检查（US）和/或计算机断层扫描（CT）随后发现了肾上腺转移，其中2例右侧肾上腺转移，第3例左侧肾上腺转移，在肝切除术后平均16个月成功切除。肺、淋巴结或骨骼均无转移病灶。然而，2例右侧肾上腺转移的患者在残余肝脏中也有多个小的复发灶。后者通过动脉栓塞治疗得到控制，患者在肾上腺切除术后12个月和3个月时仍存活。在另1例左侧肾上腺转移的患者中，血清甲胎蛋白水平3000 ng/ml恢复正常，肾上腺切除术后3年半情况良好。由于肝切除术后转移性肾上腺HCC没有有效的治疗方法，若临床上未发现其他远处转移，手术似乎是可行的。
