[Two cases of resectable adrenal metastases from hepatocellular carcinoma].

The first case is a 72-year-old man who underwent(palliative)anterior segmentectomy for multiple hepatocellular carcinoma tumors with a maximum diameter of 10 cm at the age of 70 years. The hepatic lesion was well controlled for some time by trans-catheter arterial chemoembolization (TACE). However, left adrenalectomy was performed 17 months after surgery when metastasis to the left adrenal gland was found. The postoperative course was uneventful and he has not experienced recurrence for 7 months. The second case is a 69-year-old man who underwent TACE at the age of 68 years because of multiple hepatocellular carcinoma tumors with a maximum diameter of 15 mm. The hepatic lesion was well controlled for some time. However, a left adrenalectomy was performed at the age of 70 years when metastasis to the left adrenal gland was found. The postoperative course was uneventful and he has not experienced recurrence for 5 months. We investigated 157 additional cases of adrenal metastasis of hepatocellular cancer. Treatments for adrenal metastases included surgical resection, artery embolization, and ethanol injection therapy, but long-term survival was most commonly observed when surgical resection was used. When the primary tumor that metastasized to the adrenal gland was controllable and no other metastases were observed, active resection was indicated.

[Occurrence of squamous cell lung carcinoma in the irradiated field after radiotherapy for breast cancer].

Radiotherapy for breast cancer reduces the incidence of disease recurrence and breast cancer mortality.However, it has also been associated with an increased risk of developing secondary cancers in exposed sites.Recently, we observed a 64-year-old woman who developed squamous cell lung carcinoma in the field irradiated with a total dose of 55 Gy after conservative breast surgery for left breast cancer 16 years previously.The patient underwent left upper lobectomy combined with chest wall resection.She had no recurrence of the breast cancer for 16 years.The secondary lung cancer tumor was of a different histological type than the primary breast cancer, and it appeared in the irradiated field.In conclusion, we regarded her lung cancer as a radiation-induced cancer, although it is difficult to clearly define radiation-induced cancer.In addition, the patient 's lung cancer may not only be a result of the late effect of irradiation, but might also be due to her smoking habit.

[A long-term survivor of a rectal carcinoid treated by use of repeat TACE for multiple intrahepatic recurrences after liver resection and MCT].

A woman between 50 and 60 years of age was diagnosed with a rectal carcinoid tumor and synchronal multiple liver metastases. We performed a transanal local resection of the rectal tumor, which was 10mm in diameter. During surgery, ultrasonography revealed 8 hypoechoic masses in the liver, and we performed a partial hepatectomy (S5/6, S8) and administered microwave coagulation therapy. Thirty-seven months after surgery, abdominal computed tomography revealed multiple low-density tumors in the bilateral lobe of the liver. We diagnosed these tumors as a recurrence of the liver metastases of the rectal carcinoid and performed trans-arterial chemo-embolization (TACE). After repeated TACE treatments, the liver metastases were controlled favorably. The patient is alive more than 50 months after diagnosis of the recurrent liver metastases. TACE appears to be effective for treating non-resectable multiple liver metastases of rectal carcinoids.