[Two cases of resectable adrenal metastases from hepatocellular carcinoma]

The first case is a 72-year-old man who underwent(palliative)anterior segmentectomy for multiple hepatocellular carcinoma tumors with a maximum diameter of 10 cm at the age of 70 years. The hepatic lesion was well controlled for some time by trans-catheter arterial chemoembolization (TACE). However, left adrenalectomy was performed 17 months after surgery when metastasis to the left adrenal gland was found. The postoperative course was uneventful and he has not experienced recurrence for 7 months. The second case is a 69-year-old man who underwent TACE at the age of 68 years because of multiple hepatocellular carcinoma tumors with a maximum diameter of 15 mm. The hepatic lesion was well controlled for some time. However, a left adrenalectomy was performed at the age of 70 years when metastasis to the left adrenal gland was found. The postoperative course was uneventful and he has not experienced recurrence for 5 months. We investigated 157 additional cases of adrenal metastasis of hepatocellular cancer. Treatments for adrenal metastases included surgical resection, artery embolization, and ethanol injection therapy, but long-term survival was most commonly observed when surgical resection was used. When the primary tumor that metastasized to the adrenal gland was controllable and no other metastases were observed, active resection was indicated.