We experienced a case of hepatocellular carcinoma with tumor recurrence in the right adrenal gland, who survived for a long period after a right adrenectomy. A 59-year-old man diagnosed as having a hepatocellular carcinoma with chronic hepatitis C underwent a partial hepatectomy (S7+S8) in 1988. PIVKA-II was markedly increased and tumor recurrence in the right adrenal gland was diagnosed. The right adrenectomy was performed in 1990 and no tumor reccurence was detected for about 7 years. Multiple intrahepatic recurrence was detected in November 1997 and died 6 months thereafter.
In autopsy cases of hepatocellular carcinoma, adrenal metastasis is frequent and its incidence has been reported to reach 13.1% However, reported clinical cases are quite rare. Fourteen cases including the present case have been reported so far. Surgical resection seems to be the best treatment for the patient with unilateral adrenal metastasis, unless other distant metastases or uncontrollable intrahepatic recurrences are detected.