Metastases of Hepatocellular Carcinoma to Unusual Sites: A 10 Year Case Study

Introduction: Hepatocellular carcinoma is the most common primary tumor of the liver, usually arising in a background of chronic hepatitis and cirrhosis. It is the fifth most common cancer worldwide comprising almost 6% of all newly diagnosed cancers.

Aim: The aim of our study is to report unusual metastasis of HCC seen in our practice.

Methods and Results: Data of 10 years were collected. A total of 30 cases diagnosed as metastatic hepatocellular carcinoma during the period 2004-2013 were retrieved and reviewed from files of the Section of Histopathology, Aga Khan University Hospital. Cases presenting with metastases to the lungs were excluded from the data. Age range of the patients was 31-84 years with mean age of 59.1 years. There were 28 males and 2 females. The most frequent unusual site of extrahepatic metastases was bone (n= 23), followed by soft tissue of the gluteal region (n=2), posterior triangle of neck (n=1), inguinal region (n=1), iliopsoas muscle (n=1), parotid region (n=1) and the eyeball region presenting as retrobulbar mass (n=1).

Conclusion: Lung and bone metastases are frequently seen in patients with HCC. However, HCC sometimes metastasizes to unusual sites/organs. An early diagnosis of these metastases by appropriate diagnostic modalities is essential and can improve the quality of the patient’s life.