Skin Metastasis From Hepatocarcinoma

Abstract

Cutaneous metastases may be the first sign of an internal neoplasm; hepatocellular carcinoma is a very rare source of skin involvement and presents with a protean morphology: papules, nodules, and masses that may be by natural sources or by artificial mechanisms. We present a 41-year-old man with hepatocellular carcinoma and hepatic cirrhosis who developed metastatic disease, which in the skin showed as a pyogenic granuloma. We analyze 38 cases from the literature and present a practical review of the subject.

The high comorbidity burden of the hepatitis C virus infected population in the United States

“…However, three conditions, benign neoplasms, genitourinary symptoms, and viral infections, were identified in our ranked list and have not been previously reported to be associated with treatment or disease progression. The prevalence of benign neoplasms were mainly of the large bowel and skin (trunk and unspecified sites), which could possibly be explained by metastasis to these sites among HCV patients with HCC but its pathophysiology is unclear and warrants further study [27,15]. In our study, the prevalence of HCC was low, but we cannot exclude the possibility that this may be an underestimation if patients were diagnosed prior to the study period.…”

“… CCS Clinical Classification Code*Odds ratios are adjusted for age, sex, and advanced liver disease status‡ Comorbidities associated with HCV treatment: (A) conditions associated with inteferon alfa or ribavirin use and (B) concurrent disease for which therapy is contraindicated; and HCV disease: (C) symptoms of HCV disease, (D) extrahepatic manifestations associated with HCV infection, and (E) conditions associated with disease progression; Unk, unknown a Of the patients who had other liver diseases, they reported abnormal liver function (69.5%), elevated transaminase/lactate dehydrogenase (26.7%), abnormal serum enzyme levels (13.8%), ascites (10.7%), and hepatomegaly (9.0%) b Of the patients who had other connective tissue disease, they mainly reported pain in limb (38.7%), myalgia and myositis unspecified (18.8%), swelling of limb (12.5%), and spasm of muscle (9.7%) c Of the patients who had other and unspecified lower respiratory disease, they mainly reported coughs (48.5%), other respiratory abnormalities (35.6%), shortness of breath (34.1%), and other lung disease e Of the patients who had other non-traumatic joint disorders, they mainly reported joint pain in the leg (25.5%), shoulder (24.1%), ankle (15.9%), and pelvis (14.4%) f Of the patients who had other skin disorders, they mainly reported other nonspecified skin eruptions (22.3%), sebaceous cyst (14.3%), actinic keratosis (12.3%), and other seborrheic keratosis (10.8%) g Of the patients who had other unspecified gastrointestinal disorders, they mainly reported diarrhea (26.7%), splenomegaly (20.3%), irritable bowel syndrome (11.9%), and unspecified site of abdominal/pelvic swelling (10.6%) h Of the patients who had other unspecified benign neoplasm, they mainly reported benign neoplasm of the large bowel (39.2%), skin trunk (14.3%), and unspecified skin (11.5%) i Of the patients who had esophageal disorders, they mainly reported esophageal reflux (62.6%), reflux esophagitis (21.1%), esophagitis unsepcified (14.5%), and esophageal varices without bleeding (13.7%) j Of the patients who had other upper respiratory disease, they mainly reported unspecified allergic rhinitis (43.0%), rhinitis due to pollen (13.6%), chronic rhinitis (12.4%), nasal cavity/other sinus disorder (12.2%), epistaxis (11.1%), and deviated nasal septum (11.0%) k Of the patients who had allergic reactions, they mainly reported unspecified dermatitis (65.9%) and other atopic dermatitis (11.1%) l Of the patients who had genitourinary symptoms and ill-defined conditions, they mainly reported hematuria (32.0%), urinary frequency (20.1%), and dysuria (18.9%) m Of the patients who had other viral infections, they mainly reported unspecified viral infections (42.8%), unspecified viral warts (22.0%), and unspecified herpes simplex (11.4%) n Of the patients who had other eye disorders, they mainly reported unspecified tear film insufficiency (19.7%), other vitreous opacities (15.9%), and vitreous degeneration (9.5%) o Chronic obstructive pulmonary disease (COPD) may be misclassified under lower respiratory disease which is a antiviral treatment contraindication [14] p Upper respiratory disease, comprising mainly of rhinitis, may reflect an under-diagnosis of thyorid disorders, which is known to be associated with HCV [15]. …”

“…p Upper respiratory disease, comprising mainly of rhinitis, may reflect an under-diagnosis of thyorid disorders, which is known to be associated with HCV [15]. …”

Metastatic Hepatocellular Carcinoma to the Skin Staining Positive With HMB-45

“…4,6 The face and scalp are the most common locations. 9 Patients that exhibit extrahepatic metastasis usually have advanced intrahepatic tumors. In a study by Natsuizaka et al, 1 73.8% of the patients with metastasis had intrahepatic tumors that were in the T3 or T4 stages.…”

“…1,3 Metastasis to skin is uncommon. 1,[4][5][6][7][8][9] Rarely, the cutaneous metastasis of HCC precedes the diagnosis of the primary tumor. 4,6 The histopathologic diagnosis of HCC is aided by the use of the relatively specific immunoperoxidase marker Hep Par 1.…”