MDT discussion of a case of adrenocortical carcinoma misdiagnosed as hepatocellular carcinoma_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

XIE Jie ,  CHEN Zheyu , LI Chuan , TANG Youyin

Department of Liver Surgery, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;

Corresponding author：

CHEN Zheyu, Email: chenzheyu71@163.com

Keywords：

hepatic adrenal rest tumor; adrenocortical carcinoma; hepatocellular carcinoma; differential diagnosis

DOI：

10.7507/1007-9424.202007014

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To summarize the clinical and imaging features of hepatic adrenal rest tumor and to explore its tissue source, diagnosis, differential diagnosis and treatment.Methods The clinical data of patient with hepatic adrenal rest tumor in the West China Hospital of Sichuan University were analyzed retrospectively. The diagnostic methods of liver adrenal junction were summarized by consulting relevant literatures.Results The patient was admitted to the hospital with right hepatic lesions. The preoperative imaging examination showed that it was the imaging features of hepatocellular carcinoma. The right hemihepatectomy was proposed. During the operation, it was found that the lesions were not from the liver, but from the retroperitoneum (The possibility of adrenal origin was very high). Then, the retroperitoneal occupying lesions was completely resected via urology surgery consultation. The pathological results showed that the tumor was adrenocortical carcinoma.Conclusions It is very difficult to accurately diagnose nature of hepatic adrenal rest tumor before operation only by results of cross-sectional imaging, especially for some adrenal tumor. It needs to fully be evaluated and even to perform multidisciplinary discussion if necessary for patients who have hepatic adrenal rest tumor before operation, so as to avoid misdiagnosis to a certain extent.

Citation： XIE Jie, CHEN Zheyu, LI Chuan, TANG Youyin. MDT discussion of a case of adrenocortical carcinoma misdiagnosed as hepatocellular carcinoma. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2020, 27(11): 1413-1417. doi: 10.7507/1007-9424.202007014 Copy

1.	Honma K. Adreno-hepatic fusion. An autopsy study. Zentralbl Pathol, 1991, 137(2): 117-122.
2.	Tajima T, Funakoshi A, Ikeda Y, et al. Nonfunctioning adrenal rest tumor of the liver: radiologic appearance. J Comput Assist Tomogr, 2001, 25(1): 98-101.
3.	Tateishi R, Yoshida H, Matsuyama Y, et al. Diagnostic accuracy of tumor markers for hepatocellular carcinoma: a systematic review. Hepatol Int, 2008, 2(1): 17-30.
4.	Silva MA, Hegab B, Hyde C, et al. Needle track seeding following biopsy of liver lesions in the diagnosis of hepatocellular cancer: a systematic review and meta-analysis. Gut, 2008, 57(11): 1592-1596.
5.	Kebebew E, Reiff E, Duh QY, et al. Extent of disease at presentation and outcome for adrenocortical carcinoma: have we made progress? World J Surg, 2006, 30(5): 872-878.
6.	Kerkhofs TM, Verhoeven RH, Van der Zwan JM, et al. Adrenocortical carcinoma: a population-based study on incidence and survival in the Netherlands since 1993. Eur J Cancer, 2013, 49(11): 2579-2586.
7.	Else T, Kim AC, Sabolch A, et al. Adrenocortical carcinoma. Endocr Rev, 2014, 35(2): 282-326.
8.	《原发性肝癌诊疗规范(年版)》编写专家委员会. 原发性肝癌诊疗规范(2019年版). 中国临床医学, 2020, 27(1): 140-160.
9.	Qin XL, Wang ZR, Shi JS, et al. Utility of serum CA19-9 in diagnosis of cholangiocarcinoma: in comparison with CEA. World J Gastroenterol, 2004, 10(3): 427-432.
10.	陈孝平. 外科学. 北京: 人民卫生出版社, 2013: 598-603.
11.	葛均波. 内科学. 北京: 人民卫生出版社, 2013: 708-711.
12.	Kleczeński A, Chachaj W, Suchnicka R, et al. Effect of insulin hypoglycemia on the blood adrenaline level and on the 24-hour urinary excretion rate of 17-hydroxysteroids (17-ohs) in patients with bronchial asthma, treated in Szczawano-spa. Pol Med J, 1967, 6(5): 1136-1142.
13.	Park BK, Kim CK, Jung BC, et al. Cortical adenoma in adrenohepatic fusion tissue: clue to making a correct diagnosis at preoperative computed tomography examination. Eur Urol, 2009, 56(6): 1082-1085.
14.	Korobkin M, Brodeur FJ, Yutzy GG, et al. Differentiation of adrenal adenomas from nonadenomas using CT attenuation values. AJR Am J Roentgenol, 1996, 166(3): 531-536.
15.	白人驹. 医学影像学. 北京: 人民卫生出版社, 2013: 184-186.
16.	Sasano H, Mason JL, Sasano N, et al. Immunolocalization of 3β-hydroxysteroid dehydrogenase in human adrenal cortex and in its disorders. Endocr Pathol, 1990, 1(2): 94-101.
17.	Chen HW, Chen YC, Hsieh MY, et al. Adrenocortical carcinoma misdiagnosed as hepatocellular carcinoma. Lancet Oncol, 2018, 19(8): e429.
18.	Dalla Valle R, Montali F, Manuguerra R, et al. Adrenal rest tumour of the liver. Dig Liver Dis, 2014, 46(8): 758.
19.	Fassnacht M, Dekkers OM, Else T, et al. European Society of Endocrinology Clinical Practice Guidelines on the management of adrenocortical carcinoma in adults, in collaboration with the European Network for the Study of Adrenal Tumors. Eur J Endocrinol, 2018, 179(4): G1-G46.
20.	Sugiyama T, Tajiri T, Hiraiwa S, et al. Hepatic adrenal rest tumor: Diagnostic pitfall and proposed algorithms to prevent misdiagnosis as lipid-rich hepatocellular carcinoma. Pathol Int, 2015, 65(2): 95-99.
21.	Park WY, Seo HI, Choi KU, et al. Three cases of adrenocortical tumors mistaken for hepatocellular carcinomas/diagnostic pitfalls and differential diagnosis. Ann Diagn Pathol, 2017, 31: 9-13.
22.	Yan BC, Gong C, Song J, et al. Arginase-1: a new immunohistochemical marker of hepatocytes and hepatocellular neoplasms. Am J Surg Pathol, 2010, 34(8): 1147-1154.
23.	Sangoi AR, McKenney JK. A tissue microarray-based comparative analysis of novel and traditional immunohistochemical markers in the distinction between adrenal cortical lesions and pheochromocytoma. Am J Surg Pathol, 2010, 34(3): 423-432.
24.	朱道方, 方卫华, 张贤生. 无症状嗜铬细胞瘤的诊疗体会. 安徽医学, 2015, 36(3): 350-351.

1. Honma K. Adreno-hepatic fusion. An autopsy study. Zentralbl Pathol, 1991, 137(2): 117-122.
2. Tajima T, Funakoshi A, Ikeda Y, et al. Nonfunctioning adrenal rest tumor of the liver: radiologic appearance. J Comput Assist Tomogr, 2001, 25(1): 98-101.
3. Tateishi R, Yoshida H, Matsuyama Y, et al. Diagnostic accuracy of tumor markers for hepatocellular carcinoma: a systematic review. Hepatol Int, 2008, 2(1): 17-30.
4. Silva MA, Hegab B, Hyde C, et al. Needle track seeding following biopsy of liver lesions in the diagnosis of hepatocellular cancer: a systematic review and meta-analysis. Gut, 2008, 57(11): 1592-1596.
5. Kebebew E, Reiff E, Duh QY, et al. Extent of disease at presentation and outcome for adrenocortical carcinoma: have we made progress? World J Surg, 2006, 30(5): 872-878.
6. Kerkhofs TM, Verhoeven RH, Van der Zwan JM, et al. Adrenocortical carcinoma: a population-based study on incidence and survival in the Netherlands since 1993. Eur J Cancer, 2013, 49(11): 2579-2586.
7. Else T, Kim AC, Sabolch A, et al. Adrenocortical carcinoma. Endocr Rev, 2014, 35(2): 282-326.
8. 《原发性肝癌诊疗规范(年版)》编写专家委员会. 原发性肝癌诊疗规范(2019年版). 中国临床医学, 2020, 27(1): 140-160.
9. Qin XL, Wang ZR, Shi JS, et al. Utility of serum CA19-9 in diagnosis of cholangiocarcinoma: in comparison with CEA. World J Gastroenterol, 2004, 10(3): 427-432.
10. 陈孝平. 外科学. 北京: 人民卫生出版社, 2013: 598-603.
11. 葛均波. 内科学. 北京: 人民卫生出版社, 2013: 708-711.
12. Kleczeński A, Chachaj W, Suchnicka R, et al. Effect of insulin hypoglycemia on the blood adrenaline level and on the 24-hour urinary excretion rate of 17-hydroxysteroids (17-ohs) in patients with bronchial asthma, treated in Szczawano-spa. Pol Med J, 1967, 6(5): 1136-1142.
13. Park BK, Kim CK, Jung BC, et al. Cortical adenoma in adrenohepatic fusion tissue: clue to making a correct diagnosis at preoperative computed tomography examination. Eur Urol, 2009, 56(6): 1082-1085.
14. Korobkin M, Brodeur FJ, Yutzy GG, et al. Differentiation of adrenal adenomas from nonadenomas using CT attenuation values. AJR Am J Roentgenol, 1996, 166(3): 531-536.
15. 白人驹. 医学影像学. 北京: 人民卫生出版社, 2013: 184-186.
16. Sasano H, Mason JL, Sasano N, et al. Immunolocalization of 3β-hydroxysteroid dehydrogenase in human adrenal cortex and in its disorders. Endocr Pathol, 1990, 1(2): 94-101.
17. Chen HW, Chen YC, Hsieh MY, et al. Adrenocortical carcinoma misdiagnosed as hepatocellular carcinoma. Lancet Oncol, 2018, 19(8): e429.
18. Dalla Valle R, Montali F, Manuguerra R, et al. Adrenal rest tumour of the liver. Dig Liver Dis, 2014, 46(8): 758.
19. Fassnacht M, Dekkers OM, Else T, et al. European Society of Endocrinology Clinical Practice Guidelines on the management of adrenocortical carcinoma in adults, in collaboration with the European Network for the Study of Adrenal Tumors. Eur J Endocrinol, 2018, 179(4): G1-G46.
20. Sugiyama T, Tajiri T, Hiraiwa S, et al. Hepatic adrenal rest tumor: Diagnostic pitfall and proposed algorithms to prevent misdiagnosis as lipid-rich hepatocellular carcinoma. Pathol Int, 2015, 65(2): 95-99.
21. Park WY, Seo HI, Choi KU, et al. Three cases of adrenocortical tumors mistaken for hepatocellular carcinomas/diagnostic pitfalls and differential diagnosis. Ann Diagn Pathol, 2017, 31: 9-13.
22. Yan BC, Gong C, Song J, et al. Arginase-1: a new immunohistochemical marker of hepatocytes and hepatocellular neoplasms. Am J Surg Pathol, 2010, 34(8): 1147-1154.
23. Sangoi AR, McKenney JK. A tissue microarray-based comparative analysis of novel and traditional immunohistochemical markers in the distinction between adrenal cortical lesions and pheochromocytoma. Am J Surg Pathol, 2010, 34(3): 423-432.
24. 朱道方, 方卫华, 张贤生. 无症状嗜铬细胞瘤的诊疗体会. 安徽医学, 2015, 36(3): 350-351.

Previous Article
RNA binding protein LARP6 affects invasion and prognosis of gastric cancer
Next Article
Database research part Ⅶ: characteristics of colorectal cancer surgery (Ⅱ)

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

MDT discussion of a case of adrenocortical carcinoma misdiagnosed as hepatocellular carcinoma

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content