Bone metastasis revealing hepatocellular carcinoma: a report of three cases with a long clinical course

We report herein three cases of hepatocellular carcinoma revealed by bone metastases. The metastases were located in the skull, the iliac bone, and the femur. The metastases were treated by radiotherapy, and/or surgery. With regard to the liver malignancy itself, two patients were treated by tamoxifen and one by chemoembolizations. Two patients are alive 27 and 31 months after the first sign, and one died 31 months after the diagnosis. In conclusion, in patients with hepatocellular carcinoma revealed by bone metastases, long survival was obtainable in a few cases, and aggressive treatment could be of interest.