Diagnosis and Treatment Report of a Case of Small Hepatocellular Carcinoma With Left Adrenal Metastasis and Hemorrhage in an Elderly Male Hepatitis B Virus Carrier

A 64-year-old male hepatitis B virus (HBV) carrier was admitted to the hospital due to long-term left lumbodorsal pain. He reported having suffered from lumbodorsal pain for 3 months. After visiting our hospital, he underwent a complete urinary system computed tomography (CT) scan, which revealed masses in the thyroid gland and liver. Subsequent efforts focused on the diagnosis, treatment, and prognostic follow-up of this disease. The key focuses of this case are as follows: the potential of small hepatocellular carcinoma for distant metastasis; the role of combined detection of alpha-fetoprotein (AFP) and protein induced by vitamin K absence or antagonist-II (PIVKA-II) in monitoring the disease condition throughout the entire treatment course of liver cancer; the possibility of hemorrhage in adrenal metastatic lesions; and the comprehensive treatment plan formulated after multidisciplinary discussions.