[Radiofrequency ablation combined with transcatheter arterial chemoembolization for the local recurrent tumor after resection of the adrenal metastasis from hepatocellular carcinoma--a case report].

We report a case of local recurrent tumor after a resection of right adrenal metastasis from hepatocellular carcinoma successfully treated with radiofrequency ablation combined with transcatheter arterial chemoembolization. The case is a man in his 80s who had a curative surgical resection and microwave coagulation therapy (MCT) for multiple hepatocellular carcinomas in February 2003. The lesions were judged to be T4, N0, M0 and Stage IV,then, he was treated as an outpatient on a regular schedule. In July 2003, a right adrenal tumor 2 cm in diameter was detected by computed tomography (CT), but the value of the adrenocortical hormones were normal on blood examination, and he was observed at regular intervals. In February 2005, the adrenal lesion enlarged to 5 cm in diameter and the value of PIVKA-II became high on blood examination, so April 2005, a surgical resection was performed, and it was diagnosed as the metastasis from HCC. In July 2008, the recurrent tumor 3 cm in diameter was observed in the right retroperitoneum. It was considered inoperable because of the past operation, and transcatheter arterial chemoembolization of an inferior adrenal artery and a fine branch through a right sub-phrenic artery was performed for the recurrent tumor, and one week after the embolization, radiofrequency ablation was treated by CT fluoroscopy guidance. Ten months after the tumor embolization combined with radiofrequency ablation, there were no local and distant recurrences observed by CT examination. Transcatheter arterial embolization combined with radiofrequency ablation is considered as a feasible and effective method for not only HCC but also for a local recurrent tumor after resection of the adrenal metastasis from hepatocellular carcinoma.