Abstract
Hepatocellular carcinoma (HCC) is a primary tumor of the liver that develops in the setting of chronic liver disease. HCC is difficult to diagnosis due to it requiring the use of multiple imaging modalities with the goal to detect tumors when they are less than or equal to 2 cm in size to allow all possible treatment options to be used. Herein, we discuss a 69-year-old male with stage IV liver cancer residing in hospice presenting with left middle finger osteomyelitis and extreme pain. Radiology revealed a destructive lesion, but pathology provided the diagnosis of metastatic hepatocellular carcinoma in his finger. Even though HCC can be diagnosed on imaging alone, this case highlights the need for biopsy to provide an accurate diagnosis
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