Resection of Adrenal Metastasis Invading Left Renal Vein Following Living Donor Liver Transplantation for Hepatocellular Carcinoma

Excerpt

Hepatocellular carcinoma (HCC) is the fifth most common type of cancer in the world, and it is the most common cancer of the liver parenchyma. It is seen more common in males and in the underdeveloped countries; it takes the second place among the fatal cancers in this gender. Various treatment modalities such as liver resection, liver transplantation, radiofrequency ablation (RFA), percutaneous alcohol or acetic acid ablation, transarterial chemoembolization (TACE), cryoablation, radiation therapy, and systemic chemotherapy can be used. Liver transplantation which is the preferred treatment for both the chronic liver disease and the localized HCC seems to be advantageous in terms of removing both the HCC and the underlying cirrhotic liver. However, post-transplant recurrence is one of the biggest problems in these patients. In 10–20% of the patients the recurrence of the HCC occurs in the lung, bone, lymph nodes, and adrenal glands, and when it happens, it significantly reduces the survival of the patients [1]. Although the overall prognosis is poor, the locoregional therapies and the surgical excision can be used for the treatment of the recurrent HCC in some selected patients [2‐5]. Solitary metastasis without any evidence of other organ involvement is the most preferred indication for surgical resection. The presence of multiple organ metastases or metastasis invading adjacent organs is not well-described criteria for the resection of the metastasis. Here, we described such an HCC recurrence in the left adrenal gland invading the left renal vein and its outcome after surgical resection. …