• Hua Jiang, Shanchao Zhao, and Ganhong Li.
• Department of Urology, The Fifth Affiliated Hospital of Zunyi Medical University, Zhuhai.
• Medicine (Baltimore). 2020 Nov 20; 99 (47): e23263.

RationaleDouble primary clear cell carcinomas of the liver (PCCCL) and kidney are extremely rare; moreover, there have been no reported cases of adrenal metastasis from primary clear cell tumors of the liver.Patient ConcernsA 47-year-old male patient was admitted to our clinic with space-occupying lesions in the left kidney and liver during a regular medical examination.DiagnosesThe tumors in the kidney and liver were diagnosed as primary clear cell carcinoma by histopathological examination.InterventionsThe patient subsequently underwent nephron-sparing surgery of the left kidney and radical partial excision of the right liver lobe by laparoscopic surgery. Transcatheter arterial chemoembolization (TACE) was performed for the patient 2 weeks after tumor resection. One month after the operation, the patient started adjuvant therapy with sorafenib (400 mg twice per day orally). However, follow-up CT imaging revealed a solid mass measuring 1.9 × 2.0 × 2.0 cm in the right adrenal gland at 2 months postoperatively, and then the patient underwent radiofrequency ablation (RFA) for the right adrenal tumor.OutcomesThe patient remained cancer free for 2 years following the diagnosis despite early right adrenal metastasis.LessonsHepatocyte immunostaining is sufficient for the diagnosis of PCCCL.

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