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[Bone metastasis revealing a hepatoma. 13 cases]
Revue Du Rhumatisme Et Des Maladies Osteo-Articulaires
|April 1, 1981
Summary
This study highlights bony metastases as an initial sign of hepatoma (liver cancer) in 13 male patients, often linked to alcoholism and presenting with neurological symptoms or bone tumors. Bone histology confirmed hepatoma in most cases.
Area of Science:
- Hepatobiliary Medicine
- Skeletal Oncology
- Diagnostic Pathology
Background:
- Hepatoma, a primary liver cancer, can metastasize to distant sites.
- Bony metastases are a known complication of various cancers, but their presentation as the initial sign of hepatoma is less common.
- Understanding the varied clinical presentations of hepatoma is crucial for early diagnosis.
Purpose of the Study:
- To report and analyze a series of 13 cases where bony metastases led to the diagnosis of hepatoma.
- To describe the clinical characteristics, diagnostic methods, and histological findings in these patients.
- To emphasize the importance of considering hepatoma in patients presenting with unexplained bone lesions.
Main Methods:
- Retrospective case series analysis of 13 patients diagnosed with hepatoma.
- Review of clinical presentations, including neurological symptoms, bone tumors, fractures, and pain.
- Histological examination of bone and liver biopsies for diagnosis and characterization of metastases.
Main Results:
- All 13 patients were male, with an average age of 64 years; 9 were severe alcoholics.
- Presenting symptoms included neurological issues (7 cases), isolated bone tumors (4 cases), spontaneous fracture (1 case), and bone pain (1 case).
- Significant weight loss (>5 kg) was common (10/13 cases). Hepatomegaly was noted in 8 cases, but 3 had no signs of liver disease. Bone metastases were often numerous at diagnosis (7/9 cases). Diagnosis was confirmed via bone histology in 11 cases and liver histology in 6 cases. Metastatic histology mirrored the primary liver tumor, with bile secretion observed in 4 cases.
Conclusions:
- Bony metastases can be the first indication of an underlying hepatoma, particularly in older males with a history of alcoholism.
- Clinical suspicion for hepatoma should be raised in patients with bone metastases, even in the absence of overt liver disease symptoms.
- Histological correlation between bone metastases and the primary liver tumor is highly reliable for diagnosis.