Multiple Bone Metastases as the First Manifestation of Hepatocellular Carcinoma in Patient with Noncirrhotic Liver.

Soo Ya Bae,Hyun Jung Kim,Moon Park,Jong Ho Lee,Hyun Ho Oh,Byeong Seok Sohn,Min Kwan Kwon

doi:10.1155/2015/512849

Abstract

Hepatocellular carcinoma (HCC) generally occurs on the background of chronic liver disease. Chronic hepatitides B and C and alcoholic liver disease are well-known risk factors for HCC, and it is uncommon in noncirrhotic liver. Extrahepatic metastasis seldom occurs in patients with early stage intrahepatic HCC and isolated bone metastases as a first documented extrahepatic metastasis is unusual presentation. In this report, we present a rare case of small solitary HCC (<3 cm) in noncirrhotic liver, presenting isolated bone metastases as a sole manifestation in patient with no well-known risk factors. This case suggests that HCC should be considered as one of differential diagnoses in patient presenting with multiple bone metastases, even in the absence of liver cirrhosis.

Highlights

Up to 10% of patients with cancer could develop symptomatic secondary spinal metastasis [1, 2]
We report a rare case of small solitary Hepatocellular carcinoma (HCC) (
Because the liver lesion or ovarian lesion was too small to conclude it as the primary cancer of the disseminated bone metastases, further evaluation with positron emission tomography-computed tomography (PET-CT) was planned

Summary

Introduction

Up to 10% of patients with cancer could develop symptomatic secondary spinal metastasis [1, 2]. Musculoskeletal system is the 3rd most common metastatic site following lung and liver. Cancers from breast, lung, prostate, hematopoietic (lymphoma or multiple myeloma), and renal origins account for the vast majority of extradural spinal metastases [1, 2]. Chronic hepatitis B viral infection, followed by alcoholic liver disease and chronic hepatitis C viral infection, is the common cause of HCC and well-known risk factors of it. The most frequent site of extrahepatic metastasis is lung, followed by lymph node, bone, and adrenal gland [7]. We report a rare case of small solitary HCC (

Case Presentation

Findings

Discussion