Yamagata Yusuke, Abe Takashige, Iwahara Naoya, Takada Kohichi, Hida Yasuhiro, Takakuwa Emi, Kikuchi Hiroshi, Matsumoto Ryuji, Osawa Takahiro, Shinohara Nobuo
Department of Urology Hokkaido University Graduate School of Medicine Sapporo Japan.
Department of Medical Oncology Sapporo Medical University School of Medicine Sapporo Japan.
IJU Case Rep. 2022 Jul 29;5(6):446-450. doi: 10.1002/iju5.12511. eCollection 2022 Nov.
We report a case of laparoscopic adrenalectomy in a salvage setting after multiple chemotherapies for neuroendocrine carcinoma.
A 49-year-old man was diagnosed with unknown primary carcinoma with single brain metastasis, and right supraclavicular and mediastinal lymph node metastases. After stereotactic radiotherapy of the brain metastasis and systemic chemotherapy, lymphadanectomy was performed. The pathologic diagnosis was neuroendocrine carcinoma. At 11 months after surgery, computed tomography revealed right adrenal metastasis. Local radiotherapy initially resulted in complete remission. However, adrenal recurrence was noted 10 months later. Laparoscopic adrenalectomy was performed with curative intent. The patient is currently alive without recurrence at 20 months after the operation.
Adrenalectomy can become a treatment option if other metastases are well-controlled with systemic therapy. Surgical elimination of oligometastases can offer long-term disease control in selected patients as part of a multimodal approach.
我们报告了一例在对神经内分泌癌进行多次化疗后的挽救性治疗中实施腹腔镜肾上腺切除术的病例。
一名49岁男性被诊断为原发性不明癌，伴有单发脑转移以及右锁骨上和纵隔淋巴结转移。在对脑转移灶进行立体定向放疗和全身化疗后，实施了淋巴结清扫术。病理诊断为神经内分泌癌。术后11个月，计算机断层扫描显示右肾上腺转移。局部放疗最初导致完全缓解。然而，10个月后出现肾上腺复发。遂以治愈为目的实施了腹腔镜肾上腺切除术。患者术后20个月仍存活，无复发。
如果其他转移灶通过全身治疗得到良好控制，肾上腺切除术可成为一种治疗选择。作为多模式治疗方法的一部分，手术切除寡转移灶可为部分患者提供长期疾病控制。
