[Massive osteoplastic bone metastasis of hepatocellular carcinoma--a case report]

Massive osteoplastic bone tumor in hepatocellular carcinoma is very rare. A 48-year-old man was misdiagnosed as osteosarcoma of the right proximal tibia with dense sclerosis and marked periosteal spiculation. Histologically, there were many osteoids and immature trabeculi. Tumor cells with spindle nuclei were not atypical and had few mitoses. Three years later, he suddenly died of rupture of cerebral aneurysm. Autopsy revealed small hepatocellular carcinoma with distant metastases of the tibia, lumbar spine and lung. In this case, it was extremely difficult to decide whether or not we were dealing with primary malignant tumor.