Case Of Metastatic Hepatocellular Carcinoma Research Articles

A case of metastatic hepatocellular carcinoma in the nasal cavity

Metastatic hepatocellular carcinoma in the nasal cavity and paranasal sinuses is rare. We report the case of a 71-year-old male afflicted with hepatocellular carcinoma with metastasis in the maxillary sinus and nasal cavity. He underwent radiation therapy with a total dose of 36 Gy, but he died of terminal liver failure. The possible metastatic route and prognosis of metastatic hepatocellular carcinoma in the sinonasal tract are discussed.

Unusual Metastasis of Hepatocellular Carcinoma to the Esophagus

This report describes a case of metastatic hepatocellular carcinoma (HCC) presenting as a polypoid mass in the lower esophagus. The patient was a 63-year-old man with HCC. An endoscopic examination revealed a pedunculated polypoid mass, about 3 cm in diameter, at the lower part of the esophagus. The biopsy specimen obtained from the tumor revealed that the mass consisted of a pseudoglandular arrangement of tumor cells, and the tumor was diagnosed as metastatic HCC. There were no symptoms due to esophageal tumor. He died of progressive hepatic failure. Cases of premortem-diagnosed esophageal metastasis from HCC are extremely rare.

肝細胞癌の鼻腔転移症例

Metastatic carcinoma to the nose and paranasal sinuses is relatively rare. In Japan, only 21 cases of metastatic hepatocellular carcinoma (HCC) to the nose and paranasal sinuses were reported. We report the clinical manifestation of a rare case of HCC with metastasis to the left nasal cavity.A 67-year-old man treated for HCC for 6 years had undergone the right lung upper lobectomy for metastatic HCC to the right lung 5 years earlier. His chief complaint was epistaxis. Anterior rhinoscopy showed a tumor in the left nasal cavity. CT showed a mass 2cm in diameter in the left nasal cavity, which did not extend to paranasal sinuses. The serum PIVKA-II was 4, 340AU/ml, AFP 10ng/ml, CEA 3.0ng/ml and CA19-949ng/ml. We biopsied the nasal tumor, which revealed metastatic HCC. Because of multiple lung metastasis, we didn't attempt radical surgery for the nasal tumor. Due to severe postbiopsy hemorrhage, anemia developed. To improve the patient's general condition, we embolized the artery feeding the tumor, resected the nasal tumor, and undertook reconstruction with a forehead flap. Postoperative epistaxis did not occur. The man's respiratory function was decreased by multiple lung metastasis and MRSA infection, and he died of sepsis and DIC after two weeks.In conclusion, the possibility of metastatic tumor should be considered in differential head and neck diagnosis. If metastatic HCC is suspected, biopsy should be avoided to prevent severe postbiopsy hemorrhage. Instead of biopsy, fine-needle aspiration is recommended. Chemotherapy and radiotherapy were effective in severe postbiopsy hemorrhage. If we had conducted chemotherapy or radiotherapy instead of tumor resection, the prognosis may have been better.

Metastatic hepatocellular carcinoma of gingiva mimicking pyogenic granuloma

We report a case of metastatic hepatocellular carcinoma of gingiva mimicking pyogenic granuloma. To our knowledge, no such reports have been published in the literature of dermatology. Gingival metastatic lesions are of interest both because they are easily mistaken for several benign lesions and because they may be the first sign of an undiscovered malignancy.

The usefulness of digital subtraction imaging with Levovist in the diagnosis of focal hepatic tumors

This study was designed to evaluate digital subtraction imaging (DSI) with Levovist in the diagnosis of hepatocellular carcinoma (HCC), metastatic hepatocellular carcinoma, and hepatic hemangioma. The subjects in this study were 70 patients with 76 nodules of hepatic tumors (48 nodules in 46 cases of hepatocellular carcinoma, 20 nodules in 16 cases of metastatic hepatocellular carcinoma, and 8 nodules in 8 cases of hepatic hemangioma). Contrast enhancement of tumors acquired in the early, portal, and late phases with DSI were compared to classify the tumors. DSI of HCC showed contrast enhancement of 40 nodules (82.2%). High contrast enhancement in the early phase, which was maintained in the portal phase, changed to images with no contrast enhancement with partial persistence of contrast enhancement in the late phase. DSI of metastatic hepatic carcinomas demonstrated contrast enhancement of tumor of 18 nodules (90%) to a high degree in the early and portal phases, which changed to images with no contrast enhancement in the late phases. DSI of hepatic hemangioma maintained high contrast enhancement on tumor margins of 5 nodules (62.5%) and on the entire tumor of 3 nodules (37.5%) in the early, portal, and late phases. DSI of hepatic tumors (hepatocellular carcinoma, metastatic hepatocellular carcinoma, and hepatic hemangioma) provided characteristic findings of contrast enhancement in the early, portal, and late phases, and contribute to differential diagnosis.

Metastatic hepatocellular carcinoma of the maxillary sinus: a rare autopsy case without lung metastasis and a review

A rare case of metastatic hepatocellular carcinoma (HCC) of the maxillary sinus in a 67-year-old man is reported along with the findings at autopsy. A fine needle aspiration biopsy specimen revealed a characteristic tumour structure resembling primary HCC. At autopsy, metastatic lesions were recognized in the bilateral adrenals, spleen, sternum, vertebrae and lymph node at the lesser curvature of the stomach, but not in the lung, suggesting that the HCC had metastasized to the maxillary sinus via the plexus venous vertebralis and/or the azygos vein, or lymph duct. In our reviewed 29 cases of metastatic HCC in the oro-maxillofacial region, most patients were men in the 50- to 70-year age range. At least 11 cases did not have lung metastasis, and in 18, metastasis to the oro-maxillofacial region was the first sign of HCC. One should be aware of the possibility to encounter the oral lesion as first sign of metastatic HCC.

METASTATIC HEPATOCELLULAR CARCINOMA OF THE DISTAL PHALANX OF THE THUMB: A CASE REPORT

A case of metastatic hepatocellular carcinoma of the distal phalanx of the thumb is presented. This case illustrated a rare example of acrometastasis of hepatocellular carcinoma.

Initial presentation of hepatocellular carcinoma as a mandibular mass: Case report and review of the literature

Hepatocellular carcinoma metastatic to the oral cavity is a rare phenomeon. From 1957 to date, 51 cases have been documented in the English literature. In this report we describe a case of metastatic hepatocellular carcinoma manifesting itself as unilateral mandibular paresthesia before the discovery of the primary tumor. In addition, we review the literature related to metastatic hepatocellular carcinoma and the pathways of metastasis.

Needle biopsy of the adrenal gland: retrospective review of 54 cases.

A retrospective review of 54 cases of adrenal gland needle biopsy in 53 patients is presented. The cases included 43 fine-needle aspirations (FNA), six core-needle biopsies, and five cases in which both types of needle biopsy were done. Clinical or histologic follow-up was available in 28 of the 36 specimens deemed adequate for evaluation. Metastatic malignancies represented the largest group of cases (19), with lung being the most common primary site (8). The series included four cases of metastatic hepatocellular carcinoma. Probable adrenocortical adenoma was the next most common diagnosis (12 cases). Cases causing diagnostic confusion included a case of metastatic well-differentiated hepatocellular carcinoma which was initially confused with an adrenocortical adenoma and a probable adrenocortical adenoma which was mistaken for a metastatic small round cell malignancy. (This case is unproved because of lack of clinical or histologic follow-up). By evaluating only those cases with histologic confirmation or clinical follow-up greater than one year, the sensitivity of needle biopsy for the presence of malignancy was 95% and the specificity was 100%. The cytologic findings are described with attention to the potential problem of confusing primary adrenocortical neoplasms with metastases from hepatocellular carcinoma.

Metastases to the mouth and jaws from hepatocellular carcinomas. A case report

Hepatocellular carcinoma metastasis to the jaw and soft tissue of the oral cavity is a rare phenomenon. A case of metastatic hepatocellular carcinoma to the mandible is described. A review of the literature showed that only 19 such cases have been reported so far. As severe haemorrhage may occur during surgical removal of these metastases, it is advisable to carry out fine needle aspiration biopsy when metastasis from a hepatocellular carcinoma is suspected.