Abstract

Extrahepatic spread of hepatocellular carcinoma is uncommon. Also, initial clinical presentation that manifests as symptomatic metastasis is unusual. We experienced a case the bone tumor originated from hepatocellular carcinoma that was diagnosed and successfully treated in spite of lack of histological findings. A 76-year-old man presenting severe pain of left upper arm, came to our department of orthopedic surgery and was referred to our hepatology due to be presumed left arm bone tumor as the metastatic hepatocellular carcinoma. Magnetic resonance image and positron emission tomography revealed multinodular hepatocellular carcinoma and single metastatic tumor of left upper arm. A part of left upper arm suggested to metastatic bone tumor was removed by surgical resection and replaced to artificial bone cement. The final pathological result the bone tumor tissue obtained by surgical resection was assumed an extrahepatic metastasis from unknown origin carcinoma. It was difficult to prove whether the humerus metastatic bone tumor was originated from primary hepatocellular carcinoma obviously, in view of pathologic findings. However, we could not find out any other primary carcinoma except hepatocellular carcinoma, unavoidably diagnosed humerus metastatic tumor as extrahepatic bone metastasis originating from primary hepatocellular carcinoma.

• Keywords: Hepatocellular Carcinoma;Metastasis;Bone