A 93-year-old Patient with Metachronous Bilateral Adrenal Metastases from Hepatocellular Carcinoma who has Survived for a Long Period as a Result of Repeated Laparoscopic Adrenalectomy

Abstract

We report the case of an elderly patient with metachronous bilateral adrenal metastases from hepatocellular carcinoma (HCC) who has survived for a long period as a result of repeated laparoscopic adrenalectomy. An 86-year-old man underwent microwave coagulation therapy for HCC in May 2008. A left adrenal metastasis was detected in November 2009 and was treated by laparoscopic adrenalectomy. Recurrence in the liver was detected in June 2011 and was treated by transcatheter arterial chemo-embolization (TACE). A right adrenal metastasis was detected in October 2014 and was treated by laparoscopic adrenalectomy under glucocorticoid replacement therapy. He has survived more than 7 years since the first treatment for HCC. We conclude that surgical resection is useful for adrenal metastasis from HCC even if they are bilateral. We conclude that surgical resection of adrenal metastasis under laparoscopic surgery is a low-stress curative treatment for increasing HCC among the elderly after consideration of quality of life.