Adrenalectomy for solitary recurrent hepatocellular carcinoma five years after living donor liver transplantation: A case report.
Adrenalectomy
Direct-acting antiviral agents
Hepatocellular carcinoma recurrence
Living donor liver transplantation
Journal
International journal of surgery case reports
ISSN: 2210-2612
Titre abrégé: Int J Surg Case Rep
Pays: Netherlands
ID NLM: 101529872
Informations de publication
Date de publication:
2019
2019
Historique:
received:
22
10
2018
revised:
20
11
2018
accepted:
24
11
2018
pubmed:
5
12
2018
medline:
5
12
2018
entrez:
5
12
2018
Statut:
ppublish
Résumé
The adrenal gland is a rare site for hepatocellular carcinoma (HCC) recurrence after living-donor liver transplantation (LDLT). Solitary adrenal recurrence can be managed by surgical excision, with expected better survival outcomes. We describe a rare case of successful left adrenalectomy of solitary recurrent HCC in the left adrenal gland 5 years after LDLT. 59 years male patient with HCC complicating chronic HCV infection received a right hemi-liver graft from his son. The actual graft weight was 1208 g and GRWR was 1.5. The patient started oral direct acting antiviral drugs for recurrent HCV 2 years after LDLT. A left adrenal mass was detected on follow up radiology. No other metastatic lesions were detected on metastatic workup. Left adrenalectomy was done by an anterior approach. The postoperative course was uneventful and was discharged a week after operation. Postoperative pathological and immune-histochemical examinations confirmed the metastatic HCC nature of the mass. The patient is under regular follow up with no recurrences 6 month after resection. There is no consensus regarding the management of HCC recurrence after LDLT. Most patients had multi-organ recurrences and usually offered palliative or supportive care. Solitary HCC recurrence offers a better chance for more aggressive therapy, offering better prognosis. Solitary adrenal recurrence of HCC after LDLT is extremely rare. Strict follow up protocol is necessary to allow early detection of tumor recurrence. Curative surgical resection is a safe option associated with low morbidity and expected to have a good long-term survival.
Identifiants
pubmed: 30513494
pii: S2210-2612(18)30570-4
doi: 10.1016/j.ijscr.2018.11.062
pmc: PMC6279994
pii:
doi:
Types de publication
Journal Article
Langues
eng
Pagination
23-27Informations de copyright
Copyright © 2018. Published by Elsevier Ltd.
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