[A case of solitary sternal metastasis from unknown primary hepatocellular carcinoma]

We report a 61-year-old male patient who was admitted to our hospital for treatment of a rapidly growing tumor on the anterior chest. Chest roentgenography and chest CT scan showed a mass lesion extending to the subcutaneous tissue over the sternum. Although no primary lesion was revealed by subsequent examination and needle biopsy, en-bloc resection of the chest wall tumor was performed because the patient complained of chest pain and the tumor was growing rapidly. Reconstruction of the chest wall was performed using Marlex mesh and bonecement, and the skin defect was repaired with a rectus abdominis musculocutaneous flap. No complications were observed. The pathological diagnosis of the resected specimen was a metastatic sternal tumor from a primary hepatocellular carcinoma. However, postoperative evaluation failed to detect the primary lesion in the liver. Nine months after the operation, the patient remains alive and well without evidence of hepatocellular carcinoma or recurrence. To our knowledge, reports of solitary sternal metastasis from unknown primary hepatocellular carcinoma seem to be rare.