Resection of Metachronous Adrenal Metastasis after Liver Resection and Transplantation for Hepatocellular Carcinoma

Ha, Tae‐Yong; Hwang, Shin; Ahn, Curie; Kim, Ki‐Hun; Lee, Young‐Joo; Moon, Deok‐Bog; Song, Gi‐Won; Jung, Dong‐Hwan; Park, Gil‐Chun; Lee, Sung‐Gyu

doi:10.1159/000370078

Cited by 23 publications

(24 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We previously reported a beneficial effect of surgical metastasectomy of metachronous pulmonary and adrenal metastases from HCCs on patient survival. 12 13 There are only a small number of studies supporting resection of tumors arising from peritoneal seeding of HCC, and resection of peritoneal metastases should only be considered in patients whose primary liver neoplasm is under control and who have no metastases in other organs. 14 15 16 Since there was no evidence of tumor recurrence other than localized peritoneal metastasis in the two cases described here, we decided to perform peritoneal metastasectomy in both patients.…”

Section: Discussionmentioning

confidence: 99%

Management of very late peritoneal metastasis of hepatocellular carcinoma 10 years after liver transplantation: Lessons from two cases

Alshahrani

Hwang

Song

et al. 2018

Ann Hepatobiliary Pancreat Surg

Self Cite

View full text Add to dashboard Cite

Recurrence of hepatocellular carcinoma (HCC) 10 years after liver transplantation (LT) is very rare. Here, we present two cases of peritoneal metastasis of HCC that occurred 10 and 12 years after LT. A 77-year-old male who had undergone deceased-donor LT 10 years earlier showed slow progressive elevation of tumor marker levels over 6 months. Close observation with frequent imaging studies and monthly tumor marker analyses revealed a solitary peritoneal seeding mass. Imaging studies revealed that the mass was highly likely to be metastatic HCC. After excision of the mass, all tumor markers returned to the normal range. Over past 10 months, the patient has received everolimus monotherapy and half-dose sorafenib, and has shown no evidence of HCC recurrence. In the second case, marginally elevated tumor marker levels were detected in a 65-year-old male who had undergone living-donor LT 12 years earlier. After observation for 3 months, follow-up studies revealed a peritoneal seeding mass. Thorough imaging studies revealed that the mass was highly likely to be metastatic HCC. Two mass lesions were excised, and the patient was administered low-dose calcineruin inhibitor, sirolimus, and full-dose sorafenib. Subsequently, the tumor marker levels increased again and growth of new peritoneal seeding nodules was observed; therefore, sorafenib was stopped after 2 years of administration. During 6 years since HCC recurrence diagnosis, the patient has experienced slowly growing tumors, but has been doing well. For very late peritoneal metastasis of HCC, the therapeutic modalities include surgical resection if possible, everolimus monotherapy, and long-term use of sorafenib.

show abstract

Section: Discussionmentioning

confidence: 99%

Management of very late peritoneal metastasis of hepatocellular carcinoma 10 years after liver transplantation: Lessons from two cases

Alshahrani

Hwang

Song

et al. 2018

Ann Hepatobiliary Pancreat Surg

Self Cite

View full text Add to dashboard Cite

show abstract

“…About 10-23% of patients with recurrence survive for a long time after surgical therapy (6,8,32). The median survival of unresectable cases was reported to be 5-15 months, while that of resectable cases with local recurrence was reported to be 28-65 months (33)(34)(35); cases of long-term survival after resection of the grafted liver, lung, and adrenal metastasis have also been reported (33,34,(36)(37)(38).…”

Section: Discussionmentioning

confidence: 99%

Long-term survival after resection of pharyngeal metastasis following living-donor liver transplantation for hepatocellular carcinoma: case report and review of literature

Tohyama¹,

Sakamoto²,

Tamura³

et al. 2020

Preprint

View full text Add to dashboard Cite

Background:The most common sites of recurrence after liver transplantation for hepatocellular carcinoma (HCC) have been reported to be the liver, lung, bone, and adrenal glands, but there have also been many reports of cases of multiple recurrence. The prognosis after recurrence is poor, with reported median survival after recurrence of HCC ranging from 9 to 19 months. Here, we report a case of long-term survival after recurrence of pharyngeal metastasis following living-donor liver transplantation (LDLT) for HCC within the Milan criteria, by resection of the metastatic region and cervical lymph node dissection. Case presentation:A 47-year-old man with a Model End-stage Liver Disease (MELD) score of 11 underwent LDLT for HCC within the Milan criteria on liver cirrhosis associated with hepatitis B virus infection, with his 48-year-old elder brother as the living donor. One year and 10 months after liver transplantation, he visited a nearby hospital with a chief complaint of discomfort on swallowing. A pedunculated polyp was found in the hypopharynx, and biopsy revealed HCC metastasis. Pharyngeal polypectomy was performed, followed by neck lymph node dissection 2 years thereafter. Although recurrence subsequently occurred three times in the grafted liver, the patient is still alive 12 years 10 months after recurrence of pharyngeal metastasis. He is now a tumor-free outpatient taking sorafenib. Conclusion:It is necessary to recognize that the nasopharyngeal region is a potential site of HCC metastasis. Prognostic improvement can be expected with close follow-up, early detection, and multidisciplinary treatment including radical resection.

show abstract

“…Left adrenal HCC metastases after LT are extremely rare [1,2] and reported mainly in UCSF and Milan-OUT LT recipients [3,4] (Table 1). To our knowledge, this is the first case reported of adrenal HCC metastasis that occurred after 2 years on the left adrenal gland in a Milan-IN patient at transplant.…”

Section: Discussionmentioning

confidence: 99%

Left adrenal hepatocellular carcinoma recurrence in liver transplanted patient

Maria

Parente²,

Lenci³

et al. 2019

JCRM

View full text Add to dashboard Cite

Hepatocellular carcinoma (HCC) recurrence after liver transplantation (LT) has been reported in less than 20% of patients fulfilling Milan Criteria. Mostly, it occurs within the liver, lungs, lymph nodes, bones and brain. A 45 years old Caucasian man affected by HCV-related liver cirrhosis with HCC, who underwent several multi-modal treatments, including hepatic resection, liver transplantation and loco regional treatment presented in our Department with an unusual mass within the left adrenal gland. No clinical signs were associated. However, considering his blood test and the high risk of HCC recurrence, a mini-invasive left surrenalectomy was performed showing HCC metastases in the left adrenal gland. This case shows that even extremely rare sites of HCC metastases have to be investigated, especially if, despite all available treatments, still persist a clinical or laboratory suspect.

show abstract

Resection of Metachronous Adrenal Metastasis after Liver Resection and Transplantation for Hepatocellular Carcinoma

Cited by 23 publications

References 16 publications

Management of very late peritoneal metastasis of hepatocellular carcinoma 10 years after liver transplantation: Lessons from two cases

Management of very late peritoneal metastasis of hepatocellular carcinoma 10 years after liver transplantation: Lessons from two cases

Long-term survival after resection of pharyngeal metastasis following living-donor liver transplantation for hepatocellular carcinoma: case report and review of literature

Left adrenal hepatocellular carcinoma recurrence in liver transplanted patient

Contact Info

Product

Resources

About