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Scientific letter
Adrenal metastasis as presentation of hepatocellular carcinoma
Metástasis adrenal como presentación de un hepatocarcinoma
Eugenia Sánchez Rodrígueza,
Corresponding author
, Raquel Ríos Leóna, Álvaro Flores de Miguela, Antonio Guerrero Garcíaa, Héctor Pianb, Francisco Gea Rodrígueza, Agustín Albillos Martíneza
a Servicio de Gastroenterología y Hepatología, Hospital Ramón y Cajal, Madrid, Spain
b Servicio de Anatomía Patológica, Hospital Ramón y Cajal, Madrid, Spain
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Extrahepatic disease often develops during progression of hepatocellular carcinoma&#44; but metastatic disease as an initial manifestation is rare&#46; Our case study is a 61-year old male patient who received an orthotopic liver transplantation 10 years ago due to decompensated alcohol-related cirrhosis and hepatitis <span class="elsevierStyleSmallCaps">C</span> virus infection with no virological response to earlier therapies&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Pathology tests on the explanted liver specimen ruled out the presence of hepatocellular carcinoma&#46; Following transplantation&#44; immunosuppressant therapy with ciclosporin 150<span class="elsevierStyleHsp" style=""></span>mg&#47;12<span class="elsevierStyleHsp" style=""></span>h and mycophenolate mofetil 500<span class="elsevierStyleHsp" style=""></span>mg&#47;12<span class="elsevierStyleHsp" style=""></span>h was initiated&#46; During the first few months following transplantation&#44; the patient&#39;s laboratory and histology test results were suggestive of rejection&#44; which was resolved with corticosteroid therapy&#46; The patient was then monitored using blood tests&#44; ultrasound and Fibroscan<span class="elsevierStyleSup">&#174;</span>&#44; with no evidence of significant alterations and maintaining normal liver function&#46; Nine years after the transplantation&#44; the patient was treated with a combination of sofosbuvir&#44; ledipasvir and ribavirin for 12 weeks&#44; achieving sustained virological response&#46; One year later&#44; elevated alpha-fetoprotein levels &#40;111&#46;89<span class="elsevierStyleHsp" style=""></span>IU&#47;ml&#44; increased from 7&#46;6<span class="elsevierStyleHsp" style=""></span>IU&#47;ml&#41; were observed in a routine blood test&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">A multiphase computerised axial tomography scan &#40;CT scan&#41; of the abdomen was performed&#44; which showed a liver graft of normal size and morphology&#44; and a nodule measuring 4<span class="elsevierStyleHsp" style=""></span>mm in liver segment VI with contrast uptake in the arterial phase and no evidence of washout in the venous phase&#44; LI-RADS-3&#46; A lobulated&#44; solid&#44; left adrenal mass measuring 77<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>44<span class="elsevierStyleHsp" style=""></span>mm was also described&#46; Three months later&#44; magnetic resonance imaging &#40;MRI&#41; of the abdomen showed enlargement of the adrenal lesion &#40;88<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>66<span class="elsevierStyleHsp" style=""></span>mm&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>A&#41;&#44; which was not characterisable with this imaging method&#44; and stability of the liver lesion&#46; The presence of hormone hypersecretion was ruled out&#58; thyroid function tests&#44; cortisol&#44; ACTH&#44; DHEA&#44; 17-OH progesterone&#44; urine catecholamines and cortisol suppression following dexamethasone injection were all within the normal range&#46; It was decided that it was best to surgically remove the lesion&#46; Histopathology tests &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>B&#41; revealed a metastatic carcinoma with an immunohistochemical morphology and profile consistent with hepatocellular carcinoma &#40;Hep Par-1&#44; cytoplasmic TTF-1&#44; CAM 5&#46;2 and CD10&#41;&#46; There was no infiltration of the resection margins&#46; The size of the liver lesion had remained stable on the control CT scan&#46; A PET&#47;CT scan was performed&#44; which showed no suspicious malignant lesions&#46; Today&#44; five months after surgical resection&#44; the patient is stable and shows no signs of tumour recurrence on imaging scans&#44; with alpha-fetoprotein levels of 6&#46;7<span class="elsevierStyleHsp" style=""></span>IU&#47;ml&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">Adrenal incidentalomas are extremely common&#46; Although the best way to manage such tumours has not been completely determined&#44; the first step is to rule out the presence of hormone hypersecretion and the possibility of malignancy&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Some lesions may be characterisable from imaging scans&#46; In other cases&#44; pathology testing of the lesion may be required to determine whether it is benign or malignant&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">Metastases account for 5&#37; of adrenal incidentalomas&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> The incidence of adrenal metastasis from hepatocellular carcinoma in autopsy series ranges from 4&#46;6&#37; to 12&#46;5&#37;&#44; and it is the fourth most common site of metastasis after the lungs&#44; lymph nodes and bones&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a> It has been suggested that the most likely mechanism of onset is arterial spread via the aorta&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">These lesions can be synchronous or metachronous&#44; and may appear years after liver transplantation performed to treat hepatocellular carcinoma&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a> However&#44; adrenal metastasis as the first clinical manifestation is extremely rare&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a> A literature review revealed a few cases in which metastasis was the initial manifestation of hepatocellular carcinoma&#46; Bone lesions&#44; right atrial metastases&#44; lesions in the parotid gland&#44; a mass in the gluteal region and adrenal metastases have been reported&#46;<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">4&#44;5</span></a> However&#44; in all of these cases&#44; a primary lesion was detected during follow-up&#44;<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">4&#44;5</span></a> unlike the case study presented herein&#44; in which&#44; 9 months after initial diagnosis&#44; there was no evidence of intrahepatic disease&#46; Therefore&#44; based on existing scientific evidence&#44; this is the first ever described case of adrenal metastatic disease with no evidence of a primary liver tumour&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">To conclude&#44; adrenal metastasis can be the first manifestation of the disease and must be considered if an adrenal incidentaloma is detected in patients with an increased risk of hepatocellular carcinoma&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; S&#225;nchez Rodr&#237;guez E&#44; R&#237;os Le&#243;n R&#44; Flores de Miguel &#193;&#44; Guerrero Garc&#237;a A&#44; Pian H&#44; Gea Rodr&#237;guez F&#44; et al&#46; Met&#225;stasis adrenal como presentaci&#243;n de un hepatocarcinoma&#46; Gastroenterol Hepatol&#46; 2019&#59;42&#58;171&#8211;172&#46;</p>"
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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">&#40;A&#41; MRI of metastasis in the left adrenal gland &#40;arrow&#41;&#46; &#40;B&#41; Haematoxylin&#8211;eosin staining of hepatocellular carcinoma &#40;H&#41; metastasis adjacent to normal adrenal tissue &#40;AG&#41;&#46;</p>"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Management of adrenal incidentalomas&#58; European Society of Endocrinology Clinical Practice Guideline in collaboration with the European Network for the Study of Adrenal Tumors"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Fassnacht"
                            1 => "W&#46; Arlt"
                            2 => "I&#46; Bancos"
                            3 => "H&#46; Dralle"
                            4 => "J&#46; Newell-Price"
                            5 => "A&#46; Sahdev"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1530/EJE-16-0467"
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                        "tituloSerie" => "Eur J Endocrinol"
                        "fecha" => "2016"
                        "volumen" => "175"
                        "paginaInicial" => "G1"
                        "paginaFinal" => "G34"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27390021"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Extrahepatic metastases of hepatocellular carcinoma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "S&#46; Katyal"
                            1 => "J&#46;H&#46; Oliver III"
                            2 => "M&#46;S&#46; Peterson"
                            3 => "J&#46;V&#46; Ferris"
                            4 => "B&#46;S&#46; Carr"
                            5 => "R&#46;L&#46; Baron"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1148/radiology.216.3.r00se24698"
                      "Revista" => array:6 [
                        "tituloSerie" => "Radiology"
                        "fecha" => "2000"
                        "volumen" => "216"
                        "paginaInicial" => "698"
                        "paginaFinal" => "703"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10966697"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Extrahepatic spread of hepatocellular carcinoma&#58; a pictorial review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Hong"
                            1 => "T&#46; Kim"
                            2 => "K&#46;B&#46; Sung"
                            3 => "P&#46; Kim"
                            4 => "H&#46; Ha"
                            5 => "A&#46; Kim"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00330-002-1519-7"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Radiol"
                        "fecha" => "2003"
                        "volumen" => "13"
                        "paginaInicial" => "874"
                        "paginaFinal" => "882"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12664129"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Recurrent hepatocellular carcinoma in the right adrenal gland 11 years after liver transplantation for hepatocellular carcinoma&#58; a case report and literature review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "I&#46;C&#46; Sormaz"
                            1 => "G&#46; Yegen"
                            2 => "F&#46; Akyuz"
                            3 => "F&#46; Tunca"
                            4 => "Y&#46;G&#46; &#350;eny&#252;rek"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s12262-017-1680-5"
                      "Revista" => array:6 [
                        "tituloSerie" => "Indian J Surg"
                        "fecha" => "2017"
                        "volumen" => "79"
                        "paginaInicial" => "450"
                        "paginaFinal" => "454"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29089708"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Adrenal metastasis as first presentation of hepatocellular carcinoma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "K&#46; Tsalis"
                            1 => "E&#46; Zacharakis"
                            2 => "N&#46; Sapidis"
                            3 => "I&#46; Lambrou"
                            4 => "E&#46; Zacharakis"
                            5 => "D&#46; Betsis"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/1477-7819-3-50"
                      "Revista" => array:5 [
                        "tituloSerie" => "World J Surg Oncol"
                        "fecha" => "2005"
                        "volumen" => "3"
                        "paginaInicial" => "50"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16042808"
                            "web" => "Medline"
                          ]
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                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
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