Abstract
BackgroundAs the incidence of hepatocellular carcinoma (HCC) diagnoses in Saudi Arabia has recently increased due to better diagnostic techniques, the incidence of diagnosed HCC metastasis has also increased. Here, we report a case of HCC metastasis to the rib with an initially atypical presentation of mastalgia caused by extrahepatic metastasis.Case presentationA 31-year-old woman with a prior hepatitis B viral infection presented with a mass in the left breast accompanied by mastalgia for a 6-month duration. The patient’s liver enzymes were elevated, and her serum α-fetoprotein level was particularly high. Computed tomography of her chest and abdomen showed a soft-tissue mass adhering to the upper chest wall, rib deterioration, and multiple hepatic lesions. A needle biopsy was immunohistochemically analyzed for Glypican-3, Pan-CK, and CK7 and was confirmed to be metastatic HCC.ConclusionsThis metastatic HCC case is unique because it initially presented as mastalgia. We should consider the possibility of metastatic disease when assessing patients with unusual presentations who have risk factors for metastatic carcinoma.
Highlights
As the incidence of hepatocellular carcinoma (HCC) diagnoses in Saudi Arabia has recently increased due to better diagnostic techniques, the incidence of diagnosed HCC metastasis has increased
This metastatic HCC case is unique because it initially presented as mastalgia
We should consider the possibility of metastatic disease when assessing patients with unusual presentations who have risk factors for metastatic carcinoma
Summary
EmHCC diagnosis can be challenging, physicians should be alert to the possibility of encountering this disease in their differential diagnoses.
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