An Atypical Initial Presentation of Hepatocellular Carcinoma as Spinal Cord Compression

Abstract

A young male with quiescent hepatitis B presented with sub-acute onset of lower limb weakness found to have an incidental hepatoma that had metastasized to the vertebrae causing an oncologic emergency in the form of spinal cord compression, a rare initial presentation in HBV-related hepatocellular carcinoma (HCC).

Hepatocellular carcinoma presenting as spinal cord compression in Native Americans with controlled hepatitis C: two case reports

“…Most patients with HCC present with hepatomegaly, right upper quadrant pain, and/or abdominal mass [ 12 ]. While bone metastasis is reported to occur in cases of HCC, its presentation as spinal cord compression is extremely unusual [ 5 , 12 – 14 ].…”

“…[ 4 ] 61 M n/a (paper from South Korea) Hepatitis B AST 418 U/l ALT 594 U/l HBV DNA 1890769 copies/mL Upper extremity weakness and tingling 32 2016 Sangli et al . [ 14 ] 49 M Emigrant from Ghana Hepatitis B not on medications ALT and AST WNL Left lower extremity weakness and numbness 33 2017 Ayyadurai et al . [ 13 ] 58 M n/a (paper from Bronx, USA) Hepatitis C and alcohol abuse LFTs WNL Neck pain 34 2017 Our patient 64 M Native American Hepatitis C (treated, no viral load detected) ALT 505, AST 210, bilirubin 1.5 Lower back pain and numbness 35 2017 Our patient 70 M Native American Hepatitis C Ab positive.…”