Kitagawa Y, Tajika T, Kameoka N, Kanda Y, Watanabe T, Miura A, Teramoto T, Masai O, Onuma T
Department of Surgery, Kumiai General Hospital.
Hepatogastroenterology. 1996 Sep-Oct;43(11):1383-6.
A 66-year-old man presented with an epigastric tumor demonstrated by both ultrasonography and computed tomography as hepatocellular carcinoma. He referred himself to a specialist at another hospital who performed transarterial embolization (TAE) of the hepatic artery. But the serum alpha fetoprotein (AFP) concentration gradually rose after the procedure. A right adrenal metastasis was discovered by computed tomography 9 months after his presentation, 8 months after first embolization. When TAE was performed for this metastasis, there was transverse palsy of the lower limb secondary to spinal artery embolization. He returned to our hospital where a right adrenectomy was performed 14 months after his first presentation. The operation was successful and he was discharged 6 weeks later. But he was readmitted in 8 months with an elevated serum AFP concentration and died within 2 weeks. The details of this case are presented, and the indications for resection of adrenal metastasis from hepatocellular carcinoma are discussed.
一名66岁男性因上腹部肿瘤就诊，超声检查和计算机断层扫描均显示为肝细胞癌。他转诊至另一家医院的专科医生处，接受了肝动脉经动脉栓塞术（TAE）。但术后血清甲胎蛋白（AFP）浓度逐渐升高。就诊9个月后，首次栓塞8个月后，计算机断层扫描发现右侧肾上腺转移。对该转移灶进行TAE时，继发脊髓动脉栓塞导致下肢横断性麻痹。他回到我院，首次就诊14个月后接受了右侧肾上腺切除术。手术成功，6周后出院。但8个月后他再次入院，血清AFP浓度升高，2周内死亡。本文介绍了该病例的详细情况，并讨论了肝细胞癌肾上腺转移灶切除的指征。
