Extrahepatic hepatocellular carcinoma metastasis demonstrated by technetium-99 HIDA scan

A patient presented with a 10-cm mass in the left lobe of the liver. Liver biopsy revealed hepatocellular carcinoma with abundant bile staining. A chest roentgenogram showed a 13-mm nodule in the right mid-lung field. A 99Tc HIDA scan was ordered for the evaluation of the pulmonary nodule. Intense uptake of the radionuclide was noted in the location of the nodule. The findings in this case suggest that the 99Tc HIDA scan may be a useful staging agent after the diagnosis of hepatocellular carcinoma has been documented.