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Sei Jin Youn 1 Article
A Long-Term Survival Case of Hepatocellular Carcinoma with Adrenal Gland Recurrence
Hee-Bok Chae, Seon Mee Park, Sei Jin Youn
Journal of the Korean Liver Cancer Study Group. 2001;1(1):56-59.   Published online June 30, 2001
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A 59 year-old-male patient with liver cirrhosis was admitted due to altered mentality for 1 day. Thirty-seven months ago, he was diagnosed as hepatocellular carcinoma. At the time of the initial diagnosis, physical findings were normal. Biochemical tests showed as AST (86 IU/L), ALT (68 IU/L), bilirubin (0.5 mg/dL) and AFP (268 ng/ml). Abdomen CT showed a 5 cm-sized mass at S 6. He was trated with preoperative TACE and posterior segmentectomy 1 month after TACE. The excised liver specimen showed that most of the tumor was dead due to previous TACE, the growth pattern was trabecular, and the Edmondsons differentiation grade was Ⅲ/Ⅳ. At 18 months after the operation, the CT scan showed the right adrenal gland metastasis and he was treated with hot saline injection to the adrenal gland metastasis. From 22 months to 24 months after the operation, he was treated with both external radiotherapy (total does 3000 cGy) and subcutaneous injection of interferon ( 3 million units, 3 times a week). At 28 months after the operation, TACE was done via right adrenal artery. At 33 months after the operation, the final CT showed that adrenal gland mass was growing much larger against all of these treatment modalities. Following that he suffered from spontaneous bacterial peritonitis and two episodes of hepatic encephalopathy. At 37 months after the operation, he expired due to deep encephalopathy and massive esophageal variceal bleeding. In conclusion, we report this patient as a long-term survival case after the recurrence of hepatocellular carcinoma at right adrenal gland.
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JLC : Journal of Liver Cancer