Hepatocellular carcinoma (HCC) is a tumor whose incidence has been increasing in recent years. The occurrence of cutaneous metastases from HCC, as the first sign of onset, is very unusual. We report a case of cutaneous metastasis from HCC appearing as a shoulder abscess and being the first clinical sign of the disease. We also examined the few published cases, and the diagnosis, treatment, and survival rate for this disease. Metastases of HCC should be included in the differential diagnosis of growing lesions in unusual localizations. Biopsies are required to confirm the diagnosis. The diagnosis of HCC from a cutaneous lesion is very uncommon and is associated with a poor prognosis.