Adrenalectomy for solitary recurrent hepatocellular carcinoma five years after living donor liver transplantation: A case report
Autor: | Mohamed Elmorshedi, Mohamed Elshoubary, Eman M. Ibrahim, Ahmed Monier, Khaled Zalata, Ahmed Abd El-Razik Ahmed Sultan, Rehab T. Eldesoky, Omar Fathy, Tarek Salah, Usama Shiha, Mohamed Abdel Wahab, Amr M. Yassen, Ahmed Shehta, Ahmed Farouk |
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Jazyk: | angličtina |
Rok vydání: | 2018 |
Předmět: |
medicine.medical_specialty
medicine.medical_treatment Liver transplantation Article GRWR graft to recipient weight ratio 03 medical and health sciences 0302 clinical medicine LDLT living-donor liver transplantation Medicine Pathological US ultrasound business.industry Adrenal gland MELD model for end stage liver disease Adrenalectomy SVR sustainedvirologic response Living donor liver transplantation Hepatocellular carcinoma recurrence medicine.disease Recurrent Hepatocellular Carcinoma digestive system diseases Surgery CT computed tomography medicine.anatomical_structure 030220 oncology & carcinogenesis Hepatocellular carcinoma HCV hepatitis C virus Direct-acting antiviral agents 030211 gastroenterology & hepatology Anterior approach business HCC hepatocellular carcinoma |
Zdroj: | International Journal of Surgery Case Reports |
ISSN: | 2210-2612 |
Popis: | Highlights • 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 of solitary recurrent HCC is a safe option. • It is associated with low morbidity and expected to have a good long-term survival. Introduction 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. Presentation 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. Discussion 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. Conclusion 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. |
Databáze: | OpenAIRE |
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