Symptomatic bony metastases from occult primary liver cancer

Hepatocellular carcinoma presenting as bone pain

“…is not as rare as initially reported [9]. It is uncommon however for skeletal metastases to produce the presenting symptomatology in a patient with H.C.C.…”

“…show extraheclinical behavior[ 141. In another study of primary carci-patic metastases at autopsy with the majority being found noma of the liver, Berman encountered similar diversities in the lungs and regional lymph nodes [9]. In addition to ment of Medical Media, Veterans Administration Medical Center, Des Moines, Iowa.…”

“…Such lesions are most likely due to hematogenous spread and usually occur late in the course of the disease; however, presentation due to bony involvement by an occult H.C.C. without clinical or biochemical manifestations of the primary tumor has been reported [9].…”

Clinical Experience of 123I-IMP Scintigraphy in Detecting Vertebral Bone Metastases of Hepatocellular Carcinoma

“…It has been stated that bone metastases of HCC grow in an expanding manner with osteolytic and destructive changes (1,14,19,30) and that, frequently, photon deficient or normal images are obtained on bone scintigraphy with 99mTc_MDP or similar substances (28,31). These lesions may be overlooked unless scintigrams are carefully evaluated.…”

Metastatic Hepatocellular Carcinoma of the Distal Phalanx of the Thumb: A Case Report

“…7,6,11 Hepatocellular carcinoma rarely gives rise to clinically recognised osseous metastasis. 5,[7][8][9]12 Since then, considerable number of cases have been reported mainly as single case reports, or included in autopsy studies dealing with primary carcinoma of the liver. Recent collective reviews and autopsy series have found metastatic involvement of the skeletal system in approximately 2% to 22% of cases, according to some authors.…”