Author/Authors :
bergeat, damien centre hospitalier universitaire de rennes - hepatobiliary and digestive surgery unit, Rennes, France , bergeat, damien university rennes, Rennes, France , rayar, michel university rennes, Rennes, France , rayar, michel centre hospitalier universitaire de rennes - hepatobiliary and digestive surgery unit, Rennes, France , beuzit, luc university rennes, Rennes, France , beuzit, luc centre hospitalier universitaire de rennes - imaging department, Rennes, France , sandri, giovanni battista levi centre hospitalier universitaire de rennes - hepatobiliary and digestive surgery unit, Rennes, France , dagher, julien centre hospitalier universitaire de rennes - pathology unit, Rennes, France , dagher, julien university rennes, Rennes, France , merdrignac, aude centre hospitalier universitaire de rennes - hepatobiliary and digestive surgery unit, Rennes, France , merdrignac, aude university rennes, Rennes, France , tanguy, laetitia centre hospitalier universitaire de rennes - hepatobiliary and digestive surgery unit, Rennes, France , tanguy, laetitia university rennes, Rennes, France , boudjema, karim university rennes, Rennes, France , boudjema, karim centre hospitalier universitaire de rennes - hepatobiliary and digestive surgery unit, Rennes, France , sulpice, laurent university rennes, Rennes, France , sulpice, laurent centre hospitalier universitaire de rennes - hepatobiliary and digestive surgery unit, Rennes, France , meunier, bernard university rennes, Rennes, France , meunier, bernard centre hospitalier universitaire de rennes - hepatobiliary and digestive surgery unit, Rennes, France
Abstract :
Adrenocortical carcinoma (ACC) is an uncommon and aggressive cancer occurring more frequently in women; local or distant recurrences occur in 80% of cases, typically within 1 year after curative resection. Liver is the preferred metastatic site. Herein, we report the case of a unique liver metastasis from ACC occurring 23 years after the curative prior tumor surgery. A 45-year-old woman was operated in 1991 for adrenocortical stage II without microvascular involvement or capsular infiltration. At that time, no adjuvant treatment was indicated. The initial surgery consisted on a left adrenalectomy with contemporaneous left nephrectomy and regional lymphadenectomy. Five years after surgery, the patient was considered cured. However, 23 years later, the patient presented an atypical right subcostal pain. A 4 cm liver ACC metastasis involving the segment 4 and initially diagnosed as a hemangioma was discovered. A curative resection of the segment 4 was performed. Final pathological examination confirmed the diagnosis of ACC metastasis with a complete R0 resection; no lymph node metastases were observed. This case is the latest metachronous ACC metastasis ever reported in literature. To date, the patient is alive with no signs of recurrence after a post-surgical follow-up of 13 months.
