Skull metastasis from hepatocellular carcinoma

Hsieh, Cheng Ta; Sun, Jui Ming; Tsai, Wen‐Chiuan; Tsai, Tung Han; Chiang, Yung-Hsiao; Liu, M. Y.

doi:10.1007/s00701-006-1071-3

Cited by 62 publications

(92 citation statements)

References 42 publications

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“…The second means of dissemination is via the Batson venous plexus, propagation through diploic venous channels, and because of expansion of the inner and the outer skull bones. 10,11 In our case, pathological examination of the resected mass showed vascular cancer cell emboli; therefore, we thought that the tumor cells disseminated and reached the brain hematogenously.…”

Section: Discussionmentioning

confidence: 58%

Untitled

Azarpira

Dehghanian²,

Safarian³

et al. 2014

Exp Clin Transplant

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A solitary skull metastasis from hepatocellular carcinoma is rare. A 38-year-old man with hepatocellular carcinoma presented to our institution with a palpable temporal scalp mass. We took a magnetic resonance image, and discovered an enhanced and osteolytic skull tumor. The tumor was removed by an occipital craniectomy, and the histologic diagnosis was a cranial metastasis owing to hepatocellular carcinoma.A skull metastasis owing to hepatocellular carcinoma should be considered in the differential diagnosis in patients with a subcutaneous scalp mass. Although a distant metastasis can affect the prognosis of the patient, early treatment may improve survival. Key words: Hepatoma, Scalp, Transplant IntroductionHepatocellular carcinoma (HCC) constitutes approximately 3% of all cancers and is considered one of the most common causes of death from cancer. The incidence varies widely in different areas of the world. Many cases occur in countries where there are high rates of chronic hepatitis B virus (HBV) infection. The highest incidences are found in Asian (China, Taiwan) and African countries. Many of these people are exposed to dietary aflatoxins, derived from the fungus Aspergillus flavus, that when combined with HBV infection, increase the risk of HCC. 1,2 In Western countries, the incidence is increasing, but at a much lower rate than it is in Asian countries. The major causative factors are infections with HBV or hepatitis C virus (HCV), chronic alcoholism, and exposure to aflatoxin. Hemochromatosis and hereditary tyrosinemia less commonly give rise to HCC; the tumor usually develops in persons with cirrhosis. 1,2 In Western countries, the tremendous rise in obesity, the metabolic syndrome, and diabetes also are thought to affect the incidence of HCC. Fatty liver and nonalcoholic steatohepatitis may lead to cirrhosis, and eventually, to HCC. 3 Owing to the current vaccination strategies for HBV infection, screening, and treatment for HCV infections, future incidences and the common causes of HCC may change. 2,3 Hepatocellular carcinoma usually metastasizes to regional lymph nodes and the lungs. The incidence of bone metastases is low. 3,4 Multiple extrahepatic metastases usually develop after resection of the primary liver mass that receives palliative chemotherapy. Only a solitary metastasis, such as our case, should be considered for surgical resection. We report a 38-year-old man with a solitary skull metastasis owing to HCC, who presented to us with a painless scalp mass. Case ReportAt the time of this writing, a 38-year-old man presented at our institution with a scalp mass of 1 month's duration. He had no recent history of a head trauma. On local physical examination, there was a well-defined localized mass over right temporal side of his scalp. We detected no head or neck lymphadenopathy. CASe RePORT Case Report of Skull Metastasis From HepatocellularCarcinoma After a Liver Transplant

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Section: Discussionmentioning

confidence: 58%

Untitled

Azarpira

Dehghanian²,

Safarian³

et al. 2014

Exp Clin Transplant

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“…Based on the review of the literature, however, ~10% (7/68) of patients with skull HCC metastasis presented with intracranial hemorrhagic events (18). An increased incidence of hemorrhagic events is also found in Table I.…”

Section: Discussionmentioning

confidence: 99%

“…Skull metastasis of HCC is relatively rare, in contrast to the incidence of skull metastasis in lung, breast, thyroid and prostate cancers (18). Based on the review of the literature, however, ~10% (7/68) of patients with skull HCC metastasis presented with intracranial hemorrhagic events (18).…”

Section: Discussionmentioning

confidence: 99%

Spontaneous acute epidural hematoma developed due to skull metastasis of hepatocelluar carcinoma: A case report and review of the literature

et al. 2015

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Abstract. Acute epidural hematoma (AEDH) is one of the most common pathological types of head trauma, and may develop without an accidental event, although this is uncommon. The present study reports the case of a 41-year-old male patient that developed spontaneous AEDH due to skull metastasis of hepatocellular carcinoma (HCC). The man was admitted to Chonnam National University Hwasun Hospital and Medical School due to drowsiness and right-sided hemiparesis. A computed tomography scan of the head revealed the presence of a large AEDH and a lytic bone lesion in the left posterior fossa and parieto-occipital region, which exhibited heterogeneous enhancement. The perioperative findings revealed a large amount of mixed-stage epidural hematoma and a soft hemorrhagic mass that exhibited lytic change on the occipital bone. No evidence of head trauma, such as skull fracture or scalp contusion, was detected. The pathological diagnosis was hematoma with metastatic HCC. The current study reports the rare case of a patient with a metastatic tumor located in the skull that resulted in the development of spontaneous AEDH. Once a sudden and unpredicted neurological deficit occurs in a patient with HCC that is also diagnosed with skull metastasis, the possibility of spontaneous AEDH developing from the metastasis should be considered.

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“…In a review by Laigle-Donadey et al [43] , the most common primary cancers from which SBMs originated were prostate (38%) and breast cancer (20%). The incidence of SBM from HCC has been reported to be 0.4%-1.6% [44][45][46][47] and until 2009, only 25 such cases had been reported [38] . However, the incidence of SBM from HCC increased significantly during the period between 1990 and 2001 [39] .…”

Section: Radiotherapy For Sbmsmentioning

confidence: 99%

Palliative external-beam radiotherapy for bone metastases from hepatocellular carcinoma

Hayashi

Tanaka

Hoshi

2014

WJH

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The incidence of bone metastases (BMs) from hepatocellular carcinoma (HCC) is relatively low compared to those of other cancers, but it has increased recently, especially in Asian countries. Typically, BMs from HCC appear radiologically as osteolytic, destructive, and expansive components with large, bulky soft-tissue masses. These soft-tissue masses are unique to bone metastases from HCC and often replace the normal bone matrix and exhibit expansive growth. They often compress the peripheral nerves, spinal cord, or cranial nerves, causing not only bone pain but also neuropathic pain and neurological symptoms. In patients with spinal BMs, the consequent metastatic spinal cord compression (MSCC) causes paralysis. Skull base metastases (SBMs) with cranial nerve involvement can cause neurological symptoms. Therefore, patients with bony lesions often suffer from pain or neurological symptoms that have a severe, adverse effect on the quality of life. External-beam radiotherapy (EBRT) can effectively relieve bone pain and neurological symptoms caused by BMs. However, EBRT is not yet widely used for the palliative management of BMs from HCC because of the limited number of relevant studies. Furthermore, the optimal dosing schedule remains unclear, despite clinical evidence to support single-fraction radiation schedules for primary cancers. In this review, we outline data describing palliative EBRT for BMs from HCC in the context of (1) bone pain; (2) MSCC; and (3) SBMs.© 2014 Baishideng Publishing Group Inc. All rights reserved.Key words: Hepatocellular carcinoma; Metastasis; Radiotherapy; Palliative therapy; Spinal cord compression; Skull base metastasis Core tip: Due to a lack of clinical data, external-beam radiotherapy (EBRT) for bone metastases (BMs) from hepatocellular carcinoma (HCC) is still not widely used as a palliative therapy component, and the optimal dosing schedule remains unclear. BMs from HCC typically occur as expansive, bulky soft-tissue masses; they exhibit expansive growth that compresses the peripheral nerves, spinal cord, or cranial nerves, causing both bone and neuropathic pain, and neurological symptoms. In this review, we outline the data describing palliative EBRT for BMs from HCC to treat bone pain, spinal compression, and skull base metastases.Hayashi S, Tanaka H, Hoshi H. Palliative external-beam radiotherapy for bone metastases from hepatocellular carcinoma.

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Skull metastasis from hepatocellular carcinoma

Cited by 62 publications

References 42 publications

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Spontaneous acute epidural hematoma developed due to skull metastasis of hepatocelluar carcinoma: A case report and review of the literature

Palliative external-beam radiotherapy for bone metastases from hepatocellular carcinoma

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