両側副腎,肺への異時性転移に対し外科治療により長期生存中の肝細胞癌の1例

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  • A Case of Hepatocellular Carcinoma with Long-time Survival by Successful Surgical Management of Metachronous Lung and Bilateral Adrenal Metastasis

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We report a rare case of successful surgical management for lung and bilateral adrenal metastasis after hepatic resection for hepatocellular carcinoma. A 68-year-old man admitted with a tumor about 7.5cm in diameter at hepatic S6/7, accidentally found in traumatic injury, underwent right hepatectomy in February 1998. In December 2000, a metastasizing lesion at S9 of the left lung was detected by chest CT, necessitating videoassisted partial left lung resection. In July 2001, a metastasizing lesion of the right adrenal gland was detected by abdominal CT and the right adrenal gland resected. In April 2002, a tumor about 22mm in diameter at S4 of the liver was detected and treated by radio frequency ablation. In January 2004, a tumor of the left adrenal gland was detected and the left adrenal gland resected. He has survived over 6 years since the first operation, and over 2 year and 8 months since resection of the right adrenal gland. He is alive and well now with no recurrence. Hepatocellular carcinoma easily recurs and metastasizes. In the present situation with no effective chemotherapy for hepatocellular carcinoma, surgical resection of distant metastasis may contribute to longterm survival.

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