18 May, 2022
A 54 year old lady had undergone surgery for a large right adrenal tumor in 2017. 4 years later, she developed persistent abdominal discomfort. PET-CT reveled a 7 cm size mass in left side of liver. There was no evidence of disease at any other site. Surgery entailing removal of left side of liver (left hepatectomy) was done by us. After an uneventful recovery, she was discharged to home 7 days after surgery and has been doing well since. Final biopsy report was consistent with metastatic adrenocortical tumor.
There are various types of adrenal tumors, most of which are non-cancerous and are incidentally detected on routine imaging done for another reason. Occasionally, patients develop adrenocortical cancer, which is usually localized, and surgery is the best course of treatment. Sometimes, adrenal cancer can spread to liver which if localized to a part of liver is treated with complete removal of tumour with a small part of normal healthy surrounding liver (hepatectomy). Liver resection or hepatectomy needs specialized equipment and skilled team to ensure that the surgery is done safely with good outcomes.
Patients usually present with heaviness in upper abdomen and rarely with weight loss and bone pains from extensive disease. Although, traditionally, liver metastases have largely been considered incurable, in certain cancers, removal of these by surgery (metastasectomy) helps cure or at the very least, improve survival significantly. Liver metastasis from colorectal cancers, neuroendocrine tumors, adrenocortical tumors and certain other carefully and individually selected cancers should be considered for surgical removal if completely removable. Surgery for these can usually be safely done with minimal blood loss, morbidity, and mortality with significantly improved survival.