Hepatocellular carcinoma with skeletal metastasis

Three patients with symptoms related to metastases from hepatocellular carcinoma are described. The diagnosis of the primary tumor was made at autopsy in two cases and by biopsy in one. The skeletal lesions had a lytic, expansile, and hypervascular appearance. This hypervascularity may lead to bleeding either spontaneously or following biopsy. Hepatocellular carcinoma should be included in the differential diagnosis of osteolytic, expansile, hypervascular metastases, especially when such lesions are encountered in patients with liver cirrhosis.