Localized Metastatic Recurrence of HCC following Distal Extremity Trauma: Bone Scintigraphy and Anatomicopathological...

Area of Science:

• Oncology
• Hepatology
• Musculoskeletal Oncology

Background:

• Hepatocellular carcinoma (HCC) is the most prevalent form of liver cancer.
• Untreated HCC has a poor median survival rate.
• Extrahepatic metastases, particularly to musculoskeletal tissues, often accompany nonosseous metastases at diagnosis.

Observation:

• A 61-year-old male, 1 year post-treatment for hepatic HCC, presented with a 2-month history of left wrist pain and swelling.
• The patient experienced a fall on an outstretched hand prior to symptom onset.
• Imaging revealed diffuse osteolytic lesions in the left hand and distal forearm.

Findings:

• Computed tomographic scan showed diffuse osteolytic lesions.
• Bone scan exhibited equivocal diffuse activity.
• Surgical debridement confirmed metastatic hepatocellular carcinoma.

Implications:

• This case underscores the potential for late skeletal metastases from HCC, even in patients in remission.
• It highlights the importance of considering HCC metastasis in patients with unexplained osteolytic bone lesions.
• Early recognition and diagnosis of metastatic HCC are crucial for appropriate management and patient outcomes.