Yonsei Med J.  2011 Jan;52(1):199-203. 10.3349/ymj.2011.52.1.199.

Solitary Extrahepatic Intraabdominal Metastasis from Hepatocellular Carcinoma after Liver Transplantation

• Choi SB
• Kim H
• Kim SH
• Park YN
• Kim KS

• KMID: 1106458
• DOI: http://doi.org/10.3349/ymj.2011.52.1.199

Abstract

A liver transplantation is a treatment option in selected patients with hepatocellular carcinoma (HCC). Despite the adequate selection of candidates, recurrences of HCC may still develop. Solitary extrahepatic metastasis from HCC after a liver transplantation is rare. Here we report two cases of HCC demonstrated extrahepatic recurrence to the adrenal gland and spleen, respectively, within one year after a liver transplantation. Since the treatment of solitary extrahepatic metastasis from HCC after a liver transplantation is not standardized, surgical resection was performed. In the case of HCC adrenal metastasis, innumerable intrahepatic metastases were found two months after the adrenalectomy. And 16 months after adrenalectomy, the patient expired due to tumor progression and hepatic failure. In the case of HCC splenic metastasis, postoperative radiation therapy was performed. However, two recurrent HCC nodules were found 15 months after the splenectomy and received transarterial chemoembolization (TACE). And 29 month after the splenectomy, the patient also expired as same causes of former patient.

Keyword

Hepatocellular carcinoma; adrenal metastasis; splenic metastasis; liver transplantation

MeSH Terms

Aged
Carcinoma, Hepatocellular/complications/*therapy
Humans
Liver Neoplasms/complications/*therapy
*Liver Transplantation
Male
Middle Aged
Neoplasm Metastasis/*diagnosis

Figure

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  Fig. 1 A CT scan reveals a newly-developed solitary left adrenal mass, which was 3.5 × 2.3 cm in size, homogenous, and well-demarcated, suggesting HCC metastasis (A). Pathologic specimen following adrenalectomy (B) and microscopic exam, Hematoxylin & Eosin stain, ×100 (C).

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  Fig. 2 A CT scan demonstrates a ruptured HCC located in segment VIII of the liver (A). Central bisectionectomy was performed following TACE, and the mass was a 5.7 cm HCC with 60% necrosis (B). HCC, hepatocellular carcinoma.

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  Fig. 3 A newly-developed, 3 cm-sized heterogeneous mass was found in the hilum of the spleen after liver transplantation (A and B). Pathologic specimen following splenectomy (C) and microscopic exam, Hematoxylin & Eosin stain, ×40 (D).

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