{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:07:53Z","timestamp":1786118873967,"version":"build-2736575974"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"C","license":[{"start":{"date-parts":[[2024,6,1]],"date-time":"2024-06-01T00:00:00Z","timestamp":1717200000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2024,6,1]],"date-time":"2024-06-01T00:00:00Z","timestamp":1717200000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2024,4,22]],"date-time":"2024-04-22T00:00:00Z","timestamp":1713744000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction and importance:<\/jats:title>\n                    <jats:p>Due to therapeutic advances and improvements in follow-up care, the diagnosis and treatment of extrahepatic metastases of hepatocellular carcinoma [HCC] have gained clinical significance. However, adrenal gland metastases of HCC remain a rare clinical encounter. Several systemic and local treatment options are discussed in current literature. Adrenalectomy in cases of isolated adrenal metastases with well-controlled intrahepatic lesions has been shown to benefit patients in case series.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Presentation of the case:<\/jats:title>\n                    <jats:p>This 65-year-old patient presented with suspected metachronous left sided adrenal metastasis seven years after bisegmentectomy for HCC and after undergoing trans-arterial chemoembolization [TACE] for multifocal intrahepatic recurrences while being listed for liver transplantation \u201cbeyond Milan criteria\u201d. Adrenalectomy was suggested for histopathological confirmation of the suspected metastasis and re-consideration for liver transplant. The resection was performed laparoscopically and metastasis of HCC was confirmed in histopathological analysis. Postoperatively, the patient recovered quickly. However, the patient decided against re-listing for liver transplantation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical discussion:<\/jats:title>\n                    <jats:p>Current literature suggests, that minimally-invasive adrenalectomy should be considered in patients with no more than two extrahepatic lesions, a Child-Pugh-Score of less than A5, low alpha-fetoprotein [AFP] levels &lt;100 ng\/ml and size &lt;3 cm. The oncological goal should be to achieve a tumor free extrahepatic situation with a potential oncological benefit.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Our patient presented as an ideal candidate for resection of the adrenal gland metastasis and could have been re-assessed postoperatively for liver transplantation. Still, more research is needed to improve patient-selection for metastasectomy in HCC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1016\/j.ijscr.2024.109683","type":"journal-article","created":{"date-parts":[[2024,4,28]],"date-time":"2024-04-28T10:22:38Z","timestamp":1714299758000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Case report: 65-year-old man with metachronous left sided adrenal metastasis of hepatocellular carcinoma"],"prefix":"10.1097","volume":"119","author":[{"given":"Ch.","family":"Paganetti","sequence":"first","affiliation":[{"name":"Department of Surgery, Cantonal Hospital Baselland, Liestal, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Heigl","sequence":"additional","affiliation":[{"name":"Department of Surgery, Cantonal Hospital Baselland, Liestal, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Rosenberg","sequence":"additional","affiliation":[{"name":"Department of Surgery, Cantonal Hospital Baselland, Liestal, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Vetter","sequence":"additional","affiliation":[{"name":"Department of Oncology, Cancer Center, Medical University Clinic, Cantonal Hospital Baselland, Liestal, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Haslbauer","sequence":"additional","affiliation":[{"name":"Department of Pathology, Cantonal Hospital Baselland, Liestal, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Steuerwald","sequence":"additional","affiliation":[{"name":"Praxis f\u00fcr Gastroenterologie und Hepatologie, Liestal, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"issue":"1","key":"R1-37-20260422","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/j.hbpd.2020.08.008","article-title":"Aggressive surgical approach in patients with adrenal-only metastases from hepatocellular carcinoma enables higher survival rates than standard systemic therapy","volume":"20","author":"Alexandrescu","year":"2021","journal-title":"Hepatobiliary Pancreat. 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