Hepatocellular carcinoma presenting as intracranial metastasis

The authors describe two cases of hepatocellular carcinoma presenting with the initial manifestations of an intracranial mass lesion without any symptoms or signs suggestive of the primary hepatic site of the tumor. The only clue of hepatic dysfunction was mild elevation of the SGOT and SGPT. The diagnosis could not be made until operation. It is unusual for the initial clinical presentation to be related to intracranial metastasis without evidence of hepatic involvement. Measurement of the serum alpha-fetoprotein and liver ultrasound examination are the most helpful screening tools for diagnosing hepatocellular carcinoma. The literature of hepatoma with cranial metastasis is reviewed.