BACKGROUND:Although the treatment of extrahepatic metastases from primary liver tumors is essentially palliative,solitary metastasis from such tumors offers a possibility of cure by surgical resection.The adrenal glan...BACKGROUND:Although the treatment of extrahepatic metastases from primary liver tumors is essentially palliative,solitary metastasis from such tumors offers a possibility of cure by surgical resection.The adrenal gland is an uncommon site for metastasis from primary liver tumors. METHOD:We report two cases of adrenalectomy for solitary adrenal metastasis:one from intrahepatic cholangiocarcinoma and the other from hepatocellular carcinoma. RESULTS:The patient with intrahepatic cholangiocar- cinoma had a synchronous adrenal metastasis and underwent simultaneous liver resection and adrenalectomy. However,he developed recurrent disease 17 months following surgery for which he is presently on palliative chemotherapy.The other patient underwent adrenalectomy for adrenal metastasis 3 months following liver transplantation for hepatocellular carcinoma.He is presently alive and disease-free 27 months after adrenalectomy. CONCLUSION:Carefully selected patients with solitary metastasis from primary liver tumors may be considered for resection.展开更多
Background：Treatment of adrenal metastasis from lung carcinoma may prolong survival in the selected patients.However,not all patients can undergo surgery;thus,minimally invasive ablation procedures such as radiofrequ...Background：Treatment of adrenal metastasis from lung carcinoma may prolong survival in the selected patients.However,not all patients can undergo surgery;thus,minimally invasive ablation procedures such as radiofrequency ablation （RFA） and microwave ablation （MWA） have gained acceptance as alternative treatment methods.This study summarized a 5-year single-center experience regarding the evaluation of safety and efficacy of computed tomography （CT）-guided thermal ablation in the management of adrenal metastasis originating from non-small cell lung cancer （NSCLC）.Methods：The data of NSCLC patients ablated for adrenal metastasis at the Department of Diagnostic Imaging and Interventional Radiology,General Hospital Sotiria,were retrospectively analyzed.Patients were divided into two groups：RFA group and MWA group according to the therapeutic approaches.Preprocedural blood tests included measurement of international normalized ratio,partial thromboplastin time,and platelet enumeration.A dual-phase contrast-enhanced spiral CT was performed immediately after the procedure to assess the immediate response after ablation and to screen for related complications.Follow-up was performed with CT or magnetic resonance imaging at 1,3,6 months and 1 year after ablation and every 6 months thereafter.Results：A total of 99 ablation sessions in 71 patients with adrenal metastasis originating from NSCLC were included in the final analysis.Self-limited,postablation syndrome occurred in 16/99 （16.1%） of ablation sessions.All procedures were technically successful.Immediate postablation imaging showed no contrast enhancement of the ablated tumor in all patients.Follow-up imaging at 3 months revealed local tumor progression in 8 （22.8%） patients of the RFA group and 7 （19.4%） patients of MWA group,all of them underwent a second session successfully.The 1-year assessment revealed local recurrence of the ablated tumor in six patients （17.1%） of RFA group and seven patients （19.4%） of MWA group.Among these 71 patients,those with tumor size 〉3.5 cm had a higher local recurrence rate （65.2%,15/23） than those with tumors 〈3.5 cm （16.7%,8/48;P =0.012）.There was no significant difference in the median survival time between RFA （14.0 months） and MWA （14.6 months） groups （P 〉 0.05）.Conclusions：RFA and MWA showed comparable efficacy and safety in adrenal metastasis treatment.展开更多
Chromophobe renal cell carcinoma(ChRCC) metastatic to the testis has not,to the best of our knowledge,been reported in the literature.Nor have there been reports of delayed bilateral adrenal metastasis of ChRCC.Here w...Chromophobe renal cell carcinoma(ChRCC) metastatic to the testis has not,to the best of our knowledge,been reported in the literature.Nor have there been reports of delayed bilateral adrenal metastasis of ChRCC.Here we report a case of metachronous contralateral testicular and bilateral adrenal metastasis of ChRCC in a 70-year-old man who underwent right radical nephrectomy for RCC six years ago.He was admitted to the hospital because of left intrascrotal enlargement of two-month duration.Ultrasonography revealed a mass in the upper pole of the left testis.Computed tomography(CT) showed irregular masses in the bilateral adrenal area.Left radical orchiectomy and laparoscopic bilateral adrenalectomy were performed.The pathologic examination showed metastatic ChRCC in the left testis and bilateral adrenal gland.Postoperative follow-up showed that the patient had survived for at least 56 months without recurrence.The case highlights the unique behavior of RCC with an unusual site of metastasis and favorable survival after multiple metastasectomy.展开更多
文摘BACKGROUND:Although the treatment of extrahepatic metastases from primary liver tumors is essentially palliative,solitary metastasis from such tumors offers a possibility of cure by surgical resection.The adrenal gland is an uncommon site for metastasis from primary liver tumors. METHOD:We report two cases of adrenalectomy for solitary adrenal metastasis:one from intrahepatic cholangiocarcinoma and the other from hepatocellular carcinoma. RESULTS:The patient with intrahepatic cholangiocar- cinoma had a synchronous adrenal metastasis and underwent simultaneous liver resection and adrenalectomy. However,he developed recurrent disease 17 months following surgery for which he is presently on palliative chemotherapy.The other patient underwent adrenalectomy for adrenal metastasis 3 months following liver transplantation for hepatocellular carcinoma.He is presently alive and disease-free 27 months after adrenalectomy. CONCLUSION:Carefully selected patients with solitary metastasis from primary liver tumors may be considered for resection.
文摘Background：Treatment of adrenal metastasis from lung carcinoma may prolong survival in the selected patients.However,not all patients can undergo surgery;thus,minimally invasive ablation procedures such as radiofrequency ablation （RFA） and microwave ablation （MWA） have gained acceptance as alternative treatment methods.This study summarized a 5-year single-center experience regarding the evaluation of safety and efficacy of computed tomography （CT）-guided thermal ablation in the management of adrenal metastasis originating from non-small cell lung cancer （NSCLC）.Methods：The data of NSCLC patients ablated for adrenal metastasis at the Department of Diagnostic Imaging and Interventional Radiology,General Hospital Sotiria,were retrospectively analyzed.Patients were divided into two groups：RFA group and MWA group according to the therapeutic approaches.Preprocedural blood tests included measurement of international normalized ratio,partial thromboplastin time,and platelet enumeration.A dual-phase contrast-enhanced spiral CT was performed immediately after the procedure to assess the immediate response after ablation and to screen for related complications.Follow-up was performed with CT or magnetic resonance imaging at 1,3,6 months and 1 year after ablation and every 6 months thereafter.Results：A total of 99 ablation sessions in 71 patients with adrenal metastasis originating from NSCLC were included in the final analysis.Self-limited,postablation syndrome occurred in 16/99 （16.1%） of ablation sessions.All procedures were technically successful.Immediate postablation imaging showed no contrast enhancement of the ablated tumor in all patients.Follow-up imaging at 3 months revealed local tumor progression in 8 （22.8%） patients of the RFA group and 7 （19.4%） patients of MWA group,all of them underwent a second session successfully.The 1-year assessment revealed local recurrence of the ablated tumor in six patients （17.1%） of RFA group and seven patients （19.4%） of MWA group.Among these 71 patients,those with tumor size 〉3.5 cm had a higher local recurrence rate （65.2%,15/23） than those with tumors 〈3.5 cm （16.7%,8/48;P =0.012）.There was no significant difference in the median survival time between RFA （14.0 months） and MWA （14.6 months） groups （P 〉 0.05）.Conclusions：RFA and MWA showed comparable efficacy and safety in adrenal metastasis treatment.
文摘Chromophobe renal cell carcinoma(ChRCC) metastatic to the testis has not,to the best of our knowledge,been reported in the literature.Nor have there been reports of delayed bilateral adrenal metastasis of ChRCC.Here we report a case of metachronous contralateral testicular and bilateral adrenal metastasis of ChRCC in a 70-year-old man who underwent right radical nephrectomy for RCC six years ago.He was admitted to the hospital because of left intrascrotal enlargement of two-month duration.Ultrasonography revealed a mass in the upper pole of the left testis.Computed tomography(CT) showed irregular masses in the bilateral adrenal area.Left radical orchiectomy and laparoscopic bilateral adrenalectomy were performed.The pathologic examination showed metastatic ChRCC in the left testis and bilateral adrenal gland.Postoperative follow-up showed that the patient had survived for at least 56 months without recurrence.The case highlights the unique behavior of RCC with an unusual site of metastasis and favorable survival after multiple metastasectomy.
