Can hepatocellular carcinoma (HCC) produce unconventional metastases? Four cases of extrahepatic HCC

Tumori 04/2013; 99(1):19e-23e. DOI: 10.1700/1248.13806
Source: PubMed


Aims and background:
Extrahepatic spread of hepatocellular carcinoma (HCC) diagnosed during the clinical course of the disease is not frequent; however, with the prolonged survival of HCC patients, the incidence of extrahepatic metastases seems to be increasing.

Methods and study design:
We present four unusual cases of extrahepatic metastasis from HCC: the first concerns a patient who underwent a liver transplantation for HCC with cirrhosis and three years later developed metastases in the lung and the left orbit; the second is that of a patient who developed an extraperitoneal pararectal metastasis; in the third case a large osteolytic lesion developed on the left iliac bone, and in the fourth case we found an isolated metastasis in the left mandible.

Results and conclusions:
These cases offer important information related to the unusual biology of isolated metastases from HCC after successful treatment of the primary cancer.

Download full-text


Available from: Vincenza Granata, Jun 12, 2014
23 Reads
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The present study reports two cases of mandibular metastasis from hepatocellular carcinoma (HCC), including the clinical presentation, and computed tomography (CT), histopathology and immunohistochemistry results. Space-occupying lesions occurred unilaterally as an initial mandibular manifestation. HCC metastasis was confirmed by post-surgical examination, and the primary tumor was found using CT scans. Hepatitis B virus infection history and positive results of hepatitis B surface antigen, hepatitis B e-antibody, hepatitis B core antibody and hepatitis B virus pre-S1 antigen further supported the pathogenesis of HCC. Based on the clinical findings, the characteristics of the CT scans and the histopathology and immunohistochemistry results, the mechanisms of HCC metastasis and its management are also discussed.
    Oncology letters 01/2015; 9(3). DOI:10.3892/ol.2015.2864 · 1.55 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Hepatocellular carcinoma (HCC) is the most common malignant cancer of the liver and the third ranking cause of cancer-related mortality worldwide. Following the diagnosis of HCC, intrahepatic and extrahepatic metastasis patients account for ~50-75% of all HCC cases, lung and regional lymph nodes metastasis are the most common; metastasis to bone, skin and adrenal glands are rare, orbit metastasis and intracranial invasion are extremely rare. The present study reports the rare case of a patient with HCC that metastasized to the head. The patient presented with retrobulbar and intracranial invasion, and sub-scalp extension. Based on imaging findings, the lesion was initially misdiagnosed as meningioma, however, postoperative pathological examinations resulted in a definitive diagnosis of HCC metastasis. Based on the present case and a review of the relevant literature published since 2009, the current study recommends that metastasis must be considered when diagnosing retrobulbar head lesions in patients with HCC, regardless of contradictory imaging findings and other clinical indicators, which may closely mimic the original head lesion.
    Oncology letters 02/2015; 9(2):721-726. DOI:10.3892/ol.2014.2733 · 1.55 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The incidence of hepatocellular carcinoma (HCC) in Egypt has markedly increased in the recent years, mainly due to the high incidence of hepatitis C virus (HCV) infection. Consequently, the frequency of metastatic HCC has also increased. The current study presents a series of 47 patients who were initially diagnosed as metastatic HCC. Forty seven patients with the diagnosis of extrahepatic metastases of HCC at initial presentation were included in the study. The sites of metastases were bones (17), lymph nodes (9), soft tissue (7), omentum (7), maxillary sinus (2), adrenal gland (2), brain (2) and skin (1). The diagnosis of metastatic HCC was confirmed by immunohistochemistry. The patients included in the study were 38 males and 9 females, ranging from 40 to 80 years (median 60 years). All patients were HCV-positive and 36 were cirrhotic. The diagnosis of primary HCC was confirmed in all cases, based on the typical hypervascular radiological features and/or high serum α-fetoprotein concentration, or histologic examination of liver biopsy. Metastasis of HCC should be put into consideration when evaluating metastatic carcinoma with unknown primary. This is of particular importance in the Egyptian population who has the highest prevalence of HCV infection in the world.
    Diagnostic Pathology 06/2015; 10(1):82. DOI:10.1186/s13000-015-0313-1 · 2.60 Impact Factor