Asymptomatic advanced hepatocellular carcinoma presenting with spinal cord compression
Related Experiment Video
Updated: Aug 19, 2026
Intraoperative Ultrasound in Spinal Surgery
Published on: August 17, 2022
Insights
Hepatocellular carcinoma (HCC) rarely metastasizes to bone. This case highlights an advanced HCC patient presenting with spinal cord compression despite normal liver function tests and alpha-fetoprotein levels.
Area of Science:
- Hepatology
- Oncology
- Medical Imaging
Background:
- Hepatocellular carcinoma (HCC) is a primary liver cancer, often linked to chronic hepatitis B (HBV) and C (HCV) infections leading to cirrhosis.
- Metastasis commonly affects the lungs, lymph nodes, and portal vein, with bone involvement being infrequent.
Observation:
- A patient with advanced HCC presented with spinal cord compression.
- Notably, this patient was asymptomatic, with normal liver function tests (LFTs) and alpha-fetoprotein (AFP) values.
Findings:
- The case demonstrates a rare presentation of HCC metastasis to the spine causing spinal cord compression.
- This contrasts with typical advanced HCC, which usually presents with significant clinical symptoms and abnormal biomarkers.
Implications:
- This case underscores the importance of considering rare metastatic patterns in HCC, even with normal biochemical markers.
- It suggests that spinal cord compression can be an initial presentation of advanced HCC, necessitating prompt diagnostic evaluation and intervention.
Abstract:
HCC is the most frequent primary malignancy of the liver and one of the most common cancers in the world. HCC is substantially a complication of liver cirrhosis, and because HBV and HCV are the predominant causes of chronic liver disease and cirrhosis worldwide, they have a propensity to lead to HCC. Common sites of HCC metastases include the lung, lymph nodes, and portal vein. Bony metastases are rare, and when they do occur the disease is usually far advanced and is associated with clinical manifestations of abdominal pain, weight loss, jaundice, hepato-splenomegaly, ascities, deranged LFTs, and elevated AFP. We report here a patient with asymptomatic advanced HCC, normal LFTs, and normal AFP values presenting with spinal cord compression.
