Abstract

A 42 year-old-female patient with hepatocellular carcinoma was admitted. A year and half ago, she had been diagnosed as having hepatocellular carcinoma(HCC), and treated with transarterial chemoembolization(TACE). Seven months later, Abdomen CT showed recurrence of previously treated HCC and right adrenal gland metastasis. A hepatic angiography demonstrated faint nodule in left lobe of the liver, which was treated with transarterial chemoinfusion(TACI). Right renal angiography demonstrated right adrenal gland mass standing but the embolization was impossible due to narrow vessel caliber. She was treated with total 5,460cGy radiotherapy for right adrenal gland. She was treated with TACI for HCC once more before admission. Total bilirubin was 0.2 mg/dl, AST/ALT, 30/25 IU/L, albumin, 3.8 g/dl, and PT, 100%. AFP was markedly increased to 18,870 ng/ml compared with 6,746 ng/ml at the time of diagnosis. CT demonstrated no interval change of previously treated hepatocellular carcinoma in left lobe of the liver but increased size of right adrenal mass. She was treated with left lobectomy and right adrenalectomy. Postoperative CT demonstrated no evidence of recurrence and AFP was reduced to 257.8 ng/ml. She was then treated with systemic chemotherapy with adriamycin ten times. After the end of treatment, AFP was reduced to 1.64 ng/ml.

• Keywords: Adernal gland metastasis;Hepatocellular carcinoma