Combined Transcatheter Arterial Embolization and Hepatectomy for Liver Metastasis of Adrenocortical Carcinoma—A Case Report—

Abstract

A 44-year-old woman presented with abdominal distention. Abdominal computed tomography showed a huge adrenal tumor in the left upper quadrant. A malignant adrenal tumor was suspected, and surgical resection was performed. Histopathological examination confirmed a diagnosis of Stage II adrenocortical carcinoma. One year later, she developed multiple recurrent lesions in the liver and lungs. Gradual enlargement of the hepatic lesion was observed despite long-term systemic chemotherapy including mitotane, necessitating the first hepatectomy (posterior segmentectomy). Unfortunately, multiple hepatic metastases recurred a year after the hepatectomy. Considering tumor hypervascularity, transcatheter arterial embolization (TAE) was performed and achieved complete remission except for persistence of a single lesion, which was later resected (partial hepatectomy). The patient is doing well at the time of writing this report, 5 years and 5 months after surgery. She continues to receive mitotane for stable multiple lung metastases. TAE is effective for hepatic metastasis of adrenocortical carcinoma ; however, previous reports have noted that tumor regrowth invariably occurs following TAE. In our view, hepatectomy with concomitant TAE can effectively control hepatic metastases of adrenocortical carcinoma.