A case report of advanced hepatocellular carcinoma with pulmonary and adrenal metastases that was treated with chemoradiotherapy

We report a 77-year-old man was admitted to our institution because of stage III hepatocellular carcinoma (HCC) and HCV-positive liver cirrhosis. Following transarterial chemoembolization (TAE) and radiofrequency ablation (RFA) was performed. 18 months after the first therapy, slight elevation of serum AFP level was pointed out and a metastatic lesion of the left adrenal gland was detected by computed tomography (CT). Another examinations were helpful in diagnosing the tumor as adrenal metastasis of HCC. He wished to be orally administered of UFT (300mg/day) at first and followed three times TAI (transcatheter arterial chemoinfusion) to some feeding artery was performed, but that lesion had poor tumor stain. A further 5 months later, the tumor keeping progressive, systemic chemotherapy (FP) was carried out. The FP therapy consisted of 5-FU (500 mg/body/day on day 1 to day 7/week, continuous infusion) and CDDP (10mg/body/day in 250m/ normal saline, infusion for 2 hours, on day 1 and 4/week) for 2 consecutive weeks with a subsequent one-week rest period. After 2 cycles of systemic chemotherapy, adrenal metastasis was no change and lung metastases were regressed. But serum AFP level was additionally elevated, radiotherapy (40Gy/16f) was additively performed. After 5 cycles of combined therapy, adrenal metastasis was markedly regressed and lung metastases were not detectable.