Nine-year Survival of a Case of Hepatocellular Carcinoma with Synchronous Adrenal Metastasis Treated by Multimodal Treatment Including Adrenalectomy

Abstract

A 62-year-old man was referred to our hospital and diagnosed with hepatocellular carcinoma (HCC) in segment 8 of the liver with left adrenal metastasis and renal vein tumor thrombus extending to the inferior vena cava. He was first treated with sorafenib due to poor liver function because of hepatitis C infection. The main hepatic tumor and renal vein thrombus were decreased, but the adrenal tumor increased. Therefore, left adrenalectomy combined with left nephrectomy, distal pancreatectomy, and splenectomy were performed due to suspected invasion to those adjacent organs. The main tumor was then repeatedly treated by transcatheter arterial chemoembolization, radiofrequency ablation, radiotherapy, and a molecular targeted agent. The patient has survived 9 years and 7 months with intrahepatic tumors, but without any extrahepatic lesions. To the best of our knowledge, no previous study has reported such long survival of a patient with HCC after metastasectomy of the adrenal gland without resection of the main liver tumor.