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Wide Resection of Recurrent Adrenocortical Carcinoma in a Patient with Concomitant Hepatocellular Carcinoma

大規模切除復發之腎上腺皮質癌於同時併發肝癌之病人

摘要


腎上腺皮質癌為一罕見、預後不佳之惡性腫瘤。其病患年齡分布呈現雙峰狀,其一位於五歲之前,另一高峰位於三十至四十歲之間。主要治療腎上腺皮質癌的方法包括:手術治療、藥物治療(mitotane)、以及放射線治療。即使經手術完全切除,腎上腺皮質癌仍有極高機率復發。在此,我們提出一位病患有復發性肝癌,意外發現7 公分腎上腺偶見瘤。經過腹腔鏡完全切除左腎上腺皮質癌腫瘤後復發,再次大範圍手術切除局部腫瘤與其相鄰器官之報告。

並列摘要


Introduction: Adrenocortical carcinoma (ACC) is a rare tumor with a high recurrence rate. Despite complete removal of the tumor, many patients will eventually relapse.Case Report: A 62-year-old man with recurrent hepatocellular carcinoma (HCC) who had undergone transcatheter arterial embolization six times in two consecutive years, was found to have a left adrenal incidentaloma by computed tomography (CT) of the abdomen. A stage III ACC was confirmed after surgical removal. Five months later, he underwent complete resection of recurrent ACC involving multiple adjacent organs. HCC recurrence and possible ACC recurrence were noted six months after the second surgery. The patient received Doxorubicin as systemic therapy for 3 month.Conclusions: Complete resection of locally recurrent disease (ACC) without causing severe morbidity may be feasible.

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