A case of isolated metastatic hepatocellular carcinoma arising from the pelvic bone.
10.3350/kjhep.2012.18.1.89
- Author:
Kyu Sik JUNG
1
;
Kyeong Hye PARK
;
Young Eun CHON
;
Sa Ra LEE
;
Young Nyun PARK
;
Do Yun LEE
;
Jin Sil SEONG
;
Jun Yong PARK
Author Information
1. Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. DRPJY@yuhs.ac
- Publication Type:Case Reports
- Keywords:
Hepatocellular carcinoma;
Pelvic bone;
Metastasis;
Radiotherapy;
Transarterial chemoembolization
- MeSH:
Aged;
Bone Neoplasms/*diagnosis/*pathology/radiotherapy;
Carcinoma, Hepatocellular/*pathology/radiography/*secondary;
Chemoembolization, Therapeutic;
Combined Modality Therapy;
Glypicans/metabolism;
Humans;
Keratin-1/metabolism;
Keratin-3/metabolism;
Liver Neoplasms/*pathology/radiography/*secondary;
Magnetic Resonance Imaging;
Male;
Paraffin/metabolism;
Pelvic Bones/*pathology/radiography;
Positron-Emission Tomography;
Tomography, X-Ray Computed
- From:The Korean Journal of Hepatology
2012;18(1):89-93
- CountryRepublic of Korea
- Language:English
-
Abstract:
Reports of metastatic hepatocellular carcinoma (HCC) without a primary liver tumor are rare. Here we present a case of isolated HCC that had metastasized to the pelvic bone without a primary focus. A 73-year-old man presented with severe back and right-leg pain. Radiological examinations, including computed tomography (CT) and magnetic resonance imaging (MRI), revealed a huge mass on the pelvic bone (13x10 cm). He underwent an incisional biopsy, and the results of the subsequent histological examination were consistent with metastatic hepatocellular carcinoma. The tumor cells were positive for cytokeratin (AE1/AE3), hepatocyte paraffin 1, and glypican-3, and negative for CD56, chromogranin A, and synaptophysin on immunohistochemical staining. Examination of the liver by CT, MRI, positron-emission tomography scan, and angiography produced no evidence of a primary tumor. Radiotherapy and transarterial chemoembolization were performed on the pelvic bone, followed by systemic chemotherapy. These combination treatments resulted in tumor regression with necrotic changes. However, multiple lung metastases developed 1 year after the treatment, and the patient was treated with additional systemic chemotherapy.
