Management of adrenal metastases from HCC

Kaohsiung J Med Sci August 2005 • Vol 21 • No 8 371 Hepatocellular carcinoma (HCC) is the most common primary malignancy of the liver, with extrahepatic metastasis typically found during disease progression [1,2]. Edmondson and Steiner reported from autopsy findings that the adrenal gland is the second most common site for metastasis, secondary to the lung [3]. Clinically, however, HCC metastasis to the adrenal gland is rare. When adrenal metastasis is observed, it requires aggressive management, due to the risk of rupture and internal hemorrhage. Experience in the management of adrenal metastasis from HCC is limited [4,5], and current practice calls for adrenalectomy as the main treatment option, followed by MANAGEMENT OF BILATERAL ADRENAL METASTASES