Adrenal metastasis of hepatocellular carcinoma after liver transplantation: Case report and systematic review of literature

Table 1 Description of published cases of adrenal metastasis from hepatocellular carcinoma after liver transplantation

Ref.	Age/gender	Indication for LT	AFP PreLT (ng/mL)	Child-Pugh	HCC (cm)	Time from LT-AM (meses)	AFP PreAM (ng/mL)	AM size (cm)	Adrenal location	Treatment	Follow up after am treatment	Other comments
Castroagudín et al[14]	51/male	Alcohol + HCC	2.9	NA	4	5	NA	4.4	Left	Surgical, open	43 months, alive without recurrence	Right AM after 8 months of follow-up
Mourad et al[4]	53/male	HCV + HCC	756	NA	3.3	24	143	8	Left	Surgical, open	NA
Pandey et al[19]	64/male	HBV + HCC	NA	NA	15	3	NA	6	Left	Surgical, open	24 months, alive without recurrence	Gemcitabine and 5FU after surgery
Rubio et al[2]	23/male	HBV + HCC	NA	NA	11	36	NA	2.7	Right	Surgical, open	NA	Adriamycin after LT. Everolimus after adrenalectomy
Chen et al[10]	60/male	HBV + HCC	7812	B	NA	39	55,8	4	Left	Surgical, Laparoscopic	30 months, alive without recurrence	Capecitabine and oxaliplatin after LT. Gemcitabine and 5 after adrenalectomy. Lung metastases after 30 months of LT
Choi et al[11]	71/male	HCV + HCC	87.96	A	Multiple	11	6,02	5	Left	Surgical, open	16 months, deceased after recurrence
Ha et al[15]	56.1/NA	HBV + HCC (6), HCV + HCC (1)	NA	NA	4/7 Milan criteria	42.6	NA	3.4	3 × left, 4 × right	Surgical 6 open and 1 Laparoscopic	OS after 5 years of follow-up: 85.7%. Recurrence after 3 years of follow-up: 28.6%	7 patients, 5 × living donor LT +, 2 × deceased LT
Shimokawa et al[13]	47/female	HBV + HCC	2.6	C	4 lesions (3, 2, 2 and NA)	30	319.4	3	Left	Surgical, open	38 months, alive without recurrence	Double liver recurrence (surgery + RF). Bone recurrence. Living donor LT
Jalbani et al[5]	61/male	HCV + HCC	Normal	NA	3.5	15	1,0	5.5	Right	Surgical, Laparoscopic	24 months, alive without recurrence	Everolimus after adrenalectomy
Sormaz et al[18]	55/female	Cryptogenic + HCC	NA	B	4 T3bN0M0	138	NA	10	Right	Surgical, open	36 months, alive without recurrence
Ince et al[1]	61/male	HBV + HCC	187	B	25	12	275	4	Left	Surgical, open + left nephrectomy	10 months, deceased after lung recurrence	Living donor LT. Lung recurrence after 4 months of adrenalectomy. Sorafenib
Mikulic et al[6]	56/male	Alcohol + HCC	1.3	NA	4.5	30	Normal	11.5	Left	Surgical, open	24 months, alive without recurrence	Bleeding of right AM after 12 months
Zeineddine et al[3]	72/male	HCV + HCC	NA	NA	4.2	60	13.8	4.1	Right	SBRT	NA
Kim et al[12]	49/male	Alcohol + HBV + HCC	9.3	NA	4.7	18	2.0	NA	Right	RT + mTOR inhibitor	53 months, deceased after bone and IH recurrence	Adrenal recurrence after 5 months of follow-up
This article	62/male	HCV + HCC	29.06	A	2.5 and 1.8	48	42115.26	4.2	Left	Surgical, open	27 months, alive without recurrence with high AFP	Adrenal recurrence after 14 months treated with surgery. Everolimus/siroilimus

LT: Liver trasplantation; AFP: Alpha-fetoprotein; HCC: Hepatocellular carcinoma; AM: Adrenal metastases; HBV: Hepatitis B virus; HCV: Hepatitis C virus; NA: Not available; SBRT: Stereotactic Body Radiation Therapy; RT: Radiotherapy.