[A rare case of cranial metastasis from hepatocellular carcinoma]

This is the first reported case of magnetic resonance imaging (MRI) findings of cranial metastasis from hepatocellular carcinoma. A 53-year-old male was admitted to our hospital on August 23, 1994, complaining of severe headache and a subcutaneous mass on the forehead. He was diagnosed as hepatocellular carcinoma in February, 1994, at another hospital. Because of multiple intrahepatic metastasis, he was inoperable and received transarterial embolization (TAE) on February 15, 1994. He had noticed the subcutaneous mass two months prior to admission, and its recent rapid growth, and morning headache. On admission, there was no abnormality observed by neurological and physical examination except the subcutaneous mass on his forehead, 5 x 7 cm in size. It was elastic soft and unmovable, and he felt tenderness. Laboratory examination showed only mild liver dysfunction. HBsAg was negative, and alpha-fetoprotein and PIVKA-II (Protein Induced by Vitamin K Antagonists) were within normal limit. Skull X-ray showed a round bone defect in the frontal bone. Computerized tomographic (CT) scan showed bone destruction and a well-circumscribed high density mass extending from the frontal subcutaneous region into the cranial cavity. MRI showed the tumor compressing the left frontal lobe on T1 weighted image as isointense and T2 weighted image showed a slight low intense mass. The tumor was clearly enhanced on both CT scan and MRI. Left external carotid angiogram demonstrated that the hypervascular tumor mainly fed by a frontal branch of the left superficial temporal artery in the frontal region. Tumor and bone scintigram revealed multiple bone metastasis. Lung CT scan showed no metastasis.(ABSTRACT TRUNCATED AT 250 WORDS)