First Manifestation Of Hepatocellular Carcinoma Research Articles

Comparative Findings Between 68Ga-PSMA and 18F-FDG PET/CT for Hepatocellular Carcinoma

We have reported here the case of a 69-year-old man who presented with spinal cord compression due to bone metastases as the first manifestation of hepatocellular carcinoma (HCC). For the initial staging, the patient underwent 18F-fluorodeoxyglucose (FDG) positron emission tomography/computerized tomography (PET/CT) imaging, which demonstrated mild 18F-FDG uptake in the multiple expansile osteolytic bone lesions, but no remarkable atypical 18F-FDG uptake in the liver lesion on low-doses CT. An additional PET/CT scan was performed to evaluate the prostate-specific membrane antigen (PSMA) expression, which has recently been reported to be a potential biological marker in a variety of tumors including HCC. High PSMA uptake was recorded in both the metastatic bone lesions and the primary liver lesion/tumor by the 68Ga-PSMA PET/CT.

Acute pulmonary embolism as the first manifestation of hepatocellular carcinoma

Acute pulmonary embolism as the first manifestation of hepatocellular carcinoma

폐색전증에 인한 급성 폐경색으로 발견된 간세포암종 1예

폐색전증에 인한 급성 폐경색으로 발견된 간세포암종 1예

Metastasis to the jaws as a first manifestation of hepatocellular carcinoma: report of a case and analysis of 41 cases

Abstract Introduction Hepatocellular carcinoma (HCC) is one of the most common malignancies worldwide. Local metastasis is common but metastasis to the jaw is rare with 40 reported cases in the English language literature. Report of case We describe a case of a 54-year-old man who, for the past two months, had noticed a rapidly growing facial mass in the posterior mandibular area. The patient was known to be a hepatitis C virus carrier and suffered from liver cirrhosis but the presence of HCC was unknown. Methods and results The English language literature was searched for documented cases of HCC metastasis to the jaw, applicable data was evaluated. The literature analysis revealed 41 reported cases (including the present case). In most cases (81%) the jaw lesion was the only known metastasis at the time of HCC diagnosis. Clinical presentation occurred up to 2 years before discovery of the jaw metastasis. Patients with HCC jaw metastasis have a poor survival rate with an average of 6.1 months between diagnosis and death. Conclusions This study shows that an isolated jaw mass may be the initial presentation of HCC and therefore must be considered in the differential diagnosis, especially in the presence of known liver cirrhosis or chronic viral hepatitis.

Lesion in Scalp and Skull as the First Manifestation of Hepatocellular Carcinoma.

Hepatocellular carcinoma (HCC) is the most common primary tumor of the liver and the fifth most common cancer in the world. The lungs, bone, and lymph nodes are frequent sites of metastasis of HCC. The purpose of the present study is show that metastases, although rare, must be among the differential diagnosis of skin lesions and that a diagnostic research based on these findings can be conducted. The authors report a rare case of metastatic hepatocellular injury to the scalp and skull treated by a radical surgical approach. Excision of the lesion in the scalp was performed “en bloc.” The tumor was supplied by the frontal branch of the superficial temporal artery. There are few case reports of metastatic HCC to scalp and skull; treatment of these lesions should be individualized in order to control symptoms, improve quality of life, and promote an increase in survival.

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

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.

Metastasis to the jaws as a first manifestation of hepatocellular carcinoma: Report of a case and analysis of 41 cases

IntroductionHepatocellular carcinoma (HCC) is one of the most common malignancies worldwide. Local metastasis is common but metastasis to the jaw is rare with 40 reported cases in the English language literature. Report of caseWe describe a case of a 54-year-old man who, for the past two months, had noticed a rapidly growing facial mass in the posterior mandibular area. The patient was known to be a hepatitis C virus carrier and suffered from liver cirrhosis but the presence of HCC was unknown. Methods and resultsThe English language literature was searched for documented cases of HCC metastasis to the jaw, applicable data was evaluated. The literature analysis revealed 41 reported cases (including the present case). In most cases (81%) the jaw lesion was the only known metastasis at the time of HCC diagnosis. Clinical presentation occurred up to 2 years before discovery of the jaw metastasis. Patients with HCC jaw metastasis have a poor survival rate with an average of 6.1 months between diagnosis and death. ConclusionsThis study shows that an isolated jaw mass may be the initial presentation of HCC and therefore must be considered in the differential diagnosis, especially in the presence of known liver cirrhosis or chronic viral hepatitis.

Anti-Cytokeratin CAM5.2 Monoclonal Antibody Reacted with Both Cytokeratin 7 and 8, but not Cytokeratin 18. Comment on: Hepatocellular Carcinoma Metastatic to the Gingiva as a First Manifestation of Hepatocellular Carcinoma. J Maxillofac Oral Surg (JMOSI), Published on Line: 25 February 2011; DOI: 10.1007/s12663-011-0187-z.

We read with great interest the contribution by Dr. Terada T regarding the study, entitled ‘‘Hepatocellular carcinoma metastatic to the gingiva as a first manifestation of hepatocellular carcinoma’’ [1]. The author presented a good case report, and implemented a comprehensive discussion. However, there was a typo in the ‘‘Abstract’’ section that CAM5.2 was misspelled ‘‘CAM6.2’’. Additionally, this article contains a wrong identification in the second paragraph of the ‘‘Case Report’’ section that I believe, may misguide the readers. Dr. Terada T may have inadvertently annotated that ‘‘CAM5.2 reacted with both cytokeratin 8 and 18’’. We would like to explain that the anti-cytokeratin CAM 5.2, clone CAM 5.2, is marketed by Becton–Dickinson Biosciences (Franklin Lakes, NJ). This clone primarily recognizes both human cytokeratin proteins 7 and 8, whereas it is lesser specific to cytokeratin 7. Both peptides are found in most epithelial cells, with the exception of stratified squamous epithelium [2]. As a result, it is clarified that anti-cytokeratin CAM5.2 monoclonal antibody is a marker for cytokeratin 7 and 8 but not for cytokeratin 18. This letter can help us elucidate the critical points that CK8/18 is not equivalent to CAM5.2; as well as anticytokeratin CAM5.2 should not be mistaken for monoclonal antibody CK8/18 [2, 3]. However, this finding does not detract from the study results and impressions that hepatocyte paraffin-1 (HepPar-1) (OCH1E5, Dako) is a relatively specific marker of hepatocytes and hepatocellular carcinoma. Hepatocellular carcinoma can manifest as small gingival tumors, and careful hematoxylin-eosin stain and immunoreactive HepPar-1 are useful in the diagnosis of hepatocellular carcinoma in extrahepatic metastatic sites [1].

Hepatocellular Carcinoma Metastatic to the Gingiva as a First Manifestation of Hepatocellular Carcinoma

A 55-year-old man consulted to our hospital complaining of a gingival tumor. Oral examination showed granulation tissue-like polypoid tumors (2×2×1cm) in the left upper gingiva. A clinical diagnosis of granulation tissue was made, and an incisional biopsy was performed. It showed carcinoma cells in the submucosa. They were arranged in compact and sinusoidal patterns. A few bile plugs and one Mallory-like body were recognized by meticulous examination. An immunohistochemical study showed that the tumor cells were positive for hepatocyte paraffin-1 (HepPar-1), cytokeratins (AE1/3 and CAM6.2), and p53 protein. The carcinoma cells were negative for vimentin, prostate specific antigen, CD10, and α-fetoprotein. The Ki-67 labeling was 49%. A histological diagnosis of hepatocellular carcinoma (HCC) metastatic to the gingiva was made. Then, the patient was referred to hepatology unit. A blood laboratory test showed elevated elevated liver enzymes, and positive antibody to hepatitis C virus. Liver cirrhosis was also present. Imaging modalities including US, CT, and MRI revealed multiple hepatic tumors. Metastases to other sides were not recognized. The patient was diagnosed as cirrhosis and HCC with an extrahepatic metastasis to the gingiva. The patient was now treated by chemotherapy. The present case shows that HCC can manifest as small gingival tumors, and meticulous HE examination and immunoreactive HepPar-1 are useful in the diagnosis of HCC in extrahepatic metastatic sites.

Single Cavernous Sinus Metastasis as the First Manifestation of Hepatocellular Carcinoma—A Rare Case Report and Review of Literature

Single Cavernous Sinus Metastasis as the First Manifestation of Hepatocellular Carcinoma—A Rare Case Report and Review of Literature

Absent sternum as the first manifestation of bone metastasis on bone scintigraphy.

The sternum is known as a relatively common site for bone metastases by a variety of malignant neoplasms. The usual finding is increased radiotracer uptake on bone scintigraphy, and cold metastasis is distinctly unusual. In addition, total nonvisualization of the sternum presenting as bone metastasis is extremely rare. We describe two cases with similar findings (absent sternum showing no activity of the sternal segments on bone scintigraphy), which corresponded to metastatic involvement. These findings were shown to be the first manifestation of hepatocellular carcinoma in one patient and bone metastasis in another patient with ovarian cancer.

Isolated Skull Base Metastasis as the First Manifestation of Hepatocellular Carcinoma—A Rare Case Report with Review of Literature

Hepatocellular carcinoma rarely metastasizes to skull base. We report an extremely rare case of solitary skull base metastasis without metastasis to any other site, with right third, fourth, and sixth cranial nerve palsy as the initial manifestation of the disease. The biopsy specimen of skull base lytic lesion suggested metastatic hepatocellular carcinoma. Subsequent examination revealed a large mass involving superior segment of right lobe of liver, which was confirmed as hepatocellular carcinoma on histopathological examination. Until now, there have been only 24 cases of hepatocellular carcinoma metastasizing to skull base cited in literature. We report here an unusual case of solitary skull base metastasis from hepatocellular carcinoma prior to the diagnosis of primary tumor.

Acute Pulmonary Embolism as the First Manifestation of Hepatocellular Carcinoma Complicated with Tumor Thrombi in the Inferior Vena Cava: Surgery or Not?

Acute Pulmonary Embolism as the First Manifestation of Hepatocellular Carcinoma Complicated with Tumor Thrombi in the Inferior Vena Cava: Surgery or Not?

Neoplastic portal vein thrombosis (NPVT) as first manifestation of hepatocellular carcinoma (HCC)

Neoplastic portal vein thrombosis (NPVT) as first manifestation of hepatocellular carcinoma (HCC)

Hemoperitoneum as a first manifestation of hepatocellular carcinoma in western patients with liver cirrhosis: effectiveness of emergency treatment with transcatheter arterial embolization.

Hemoperitoneum is a well-known form of hepatocellular carcinoma presentation and represents a frequent complication in countries with a high incidence of hepatocellular carcinoma, but it is rarely seen in Western countries. Our aim was to report the results and describe the arteriographic and CT-scan characteristics in a series of seven consecutive patients. They were admitted to our hospital because of hemoperitoneum due to ruptured tumor as a first manifestation of hepatocellular carcinoma, and the rupture was effectively controlled by transcatheter arterial embolization. From April 1989 to April 1998, 440 consecutive patients were admitted to our liver unit with the diagnosis of hepatocellular carcinoma and liver cirrhosis. Fourteen patients (3%) presented with acute hemoperitoneum due to tumor rupture as a first manifestation of hepatocellular carcinoma. We here report our experience in the group of patients treated by transcatheter arterial embolization. Mean age was 67.1+/-5 years (range, 61-73). All patients presented with sudden abdominal pain, abdominal distension, and four patients had symptoms of acute anemia. In all cases the ruptured tumor was subcapsular. The procedure was effective in the control of bleeding in all cases, without significant impairment in liver function or treatment-related deaths. In six of the seven patients, a self-limited postembolization syndrome was observed. Mean survival time was 273+/-488.7 days (range: 15-1290). Three patients survived more than six months but at the time of evaluation, only one patient was alive. In conclusion, the present results confirm that transcatheter arterial embolization is an effective and well-tolerated treatment in the management of hemoperitoneum due to ruptured hepatocellular carcinoma in patients with liver cirrhosis.

Rib Metastasis Revealing Hepatocellular Carcinoma

Bone metastasis infrequently appears as the first manifestation of hepatocellular carcinoma (HCC), and in any case in most patients the primary tumour is detected a few months after its development. We report the case of a patient with alcoholic liver disease, increased levels of alpha-fetoprotein, and no evidence of hepatic lesion in the different imaging modalities, in whom metastasis of HCC was detected in the ribs, whereas the primary tumour was not diagnosed until 15 months later. We believe that all patients with increased levels of alpha-fetoprotein should be tested in an intensified search for HCC and possible metastases, given that hepatic lesions may not be detected until many months after the diagnosis of metastatic disease.

Mandibular metastasis as the first manifestation of hepatocellular carcinoma: Report of a case and review of the literature

Mandibular metastasis as the first manifestation of hepatocellular carcinoma: Report of a case and review of the literature