Abstract
A 69-year-old man was initially diagnosed with sigmoid colon cancer and simultaneous S6 hepatic and bilateral adrenal metastases. After resection of the primary lesion, the patient was treated with 5 courses of chemotherapy. This was followed by a laparotomy for a posterior hepatic segmentectomy and bilateral adrenalectomy. Since the right adrenal tumor directly invaded the liver, the right adrenal gland was resected en bloc with the posterior hepatic segment. The left adrenal gland also had tumor and was completely resected.
Preoperative adrenocortical function was not decreased. Prior to intraoperative clamping of the porta hepatis for a hepatectomy, methylprednisolone was given by intravenous infusion, and on the following day, supplemental steroid therapy by intravenous infusion of hydrocortisone was started. The patient was gradually weaned from steroid therapy and switched to a maintenance dose of 15 mg/day of oral hydrocortisone on postoperative day 6. The patient improved gradually without acute adrenal insufficiency and was discharged.
Bilateral single-stage adrenalectomy for adrenal metastases from colorectal cancer has not been previously reported in Japan. [It this your intended meaning? You report primary tumor resection, 5 courses of chemotherapy, then laparotomy for hepatectomy and bilateral adrenalectomy.] This case report presents the safe performance of bilateral adrenalectomy and hepatectomy in a single stage with supplemental steroid therapy in a patient with liver and adrenal metastases from colorectal cancer.
