[Bone metastasis revealing a hepatoma. 13 cases]

The authors report a series of 13 cases of bony metastases leading to the discovery of a hepatoma. They were subjects of male sex, average age 64 years. Nine were severe alcoholics. The presenting symptoms were in 7 cases neurological, in four cases an isolated bone tumour, finally, one spontaneous fracture, and one case with pain alone. Severe loss of weight was frequent; in 10 cases out of 13 it was greater than 5 kg. Hepatomegaly was found in 8 cases, but in 3 cases there was no sign suggesting liver disease. In 7 cases out of nine, the metastases were already numerous at the time of diagnosis. The diagnosis of metastases from a hepatoma was made on the bone histology 11 times and from the hepatic histology in 6 cases. The histological of the bone metastasis reproduces very well that of the liver. In four cases there was local secretion of bile, in one case the metastatic liver cells underwent steatonecrosis.