Bone metastases as the initial presentation of hepatocellular carcinoma. Two case reports and a literature review

Sudden Collapse due to Medullary and Cervical Cord Infarction—An Unusual Presentation of Hepatocellular Carcinoma

“…The commonest site of metastases is the lungs (37–70%), followed by lymph nodes (23–45%), bone, and adrenal glands . Metastatic spread to the bones occurs in 13–16% of HCC patients , and it appears to be unique because it can rarely occur before clinical manifestations of liver disease and is usually symptomatic, commonly presenting with bone pain . When there are skeletal metastases, the common sites vary from study to study.…”

Giant hepatocellular carcinoma with bone metastasis in a young adult, emerged from pigmented adenoma with beta-Catenin activation: A case report

“…The most common sites of HCC metastases are lung (49%), abdominal organs (24%) and bone (13–16%). Skeletal metastases appear as expansive soft tissue masses with bone destruction and mainly involved sites are the vertebrae, pelvis, ribs, skull, humerus and sternum [7] .…”

Shoulder Mass as the Initial Presentation of Metastatic Hepatocellular Carcinoma

“…Rare and unusual metastatic sites have been described in the literature, including the chest wall presenting as a breast mass and metastasis to the nasal septum 5,6. Indeed, extrahepatic metastases to the humeral shoulder, chest wall, and bony lesions are exceedingly rare, as only a handful of cases have been reported 3,7. Traditionally, a few systems have been widely employed for HCC staging (e.g.…”

“… 5 , 6 Indeed, extrahepatic metastases to the humeral shoulder, chest wall, and bony lesions are exceedingly rare, as only a handful of cases have been reported. 3 , 7 Traditionally, a few systems have been widely employed for HCC staging (e.g. Okuda, tumor/node/metastasis), however, newer classification systems that take into account prognostication and treatment regimens are increasingly being utilized.…”