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An unusual case of adrenocortical carcinoma with liver metastasis that occurred at 23 years after surgery

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
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Contributor : Laurent Jonchère <>
Submitted on : Thursday, October 4, 2018 - 4:32:12 PM
Last modification on : Monday, April 6, 2020 - 11:33:53 AM

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Damien Bergeat, Michel Rayar, Luc Beuzit, Giovanni Battista Levi Sandri, Julien Dagher, et al.. An unusual case of adrenocortical carcinoma with liver metastasis that occurred at 23 years after surgery. Hepatobiliary Surgery and Nutrition, AME Publishing Company, 2016, 5 (3), pp.265--268. ⟨10.21037/hbsn.2016.03.05⟩. ⟨hal-01334069⟩

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