title: Hepatocellular carcinoma diagnosed by fine-needle aspiration of the parotid gland.
abstract: Hepatocellular carcinoma rarely metastasizes to the salivary glands. We report a case of a 47-yr-old man who presented with a right parotid lesion that was diagnosed by fine-needle aspiration (FNA) biopsy as a metastatic lesion suggestive of hepatocellular carcinoma with similar findings in a subsequent intraoral incisional biopsy. The patient's serum alpha-fetoprotein level was within normal limits at the time of diagnosis. CT scan revealed a mass in the liver, but a liver biopsy was not performed. The patient deteriorated rapidly and died about 4 mo later. An autopsy confirmed the presence of hepatocellular carcinoma with distant metastases to unusual sites, including the parotid gland, orbit, and calvarium, bypassing more common sites such as the lungs. This is the second known reported case in which hepatocellular carcinoma presented as a salivary gland metastasis. In both cases the diagnosis was made by FNA biopsy, illustrating the utility of this method for diagnosing uncommon metastatic salivary gland lesions.
authors.affiliation: Department of Pathology and Laboratory Medicine, University of Kansas Medical Center, Kansas City, Kansas, USA.
authors.forename: Maria M
authors.initials: MM
authors.lastname: Romanas
authors.forename: Rachel
authors.initials: R
authors.lastname: Cherian
authors.forename: Douglas H
authors.initials: DH
authors.lastname: McGregor
authors.forename: Yaping
authors.initials: Y
authors.lastname: Wu
authors.forename: Corrie L
authors.initials: CL
authors.lastname: May
authors.forename: Joaquina C
authors.initials: JC
authors.lastname: Baranda
mesh_terms: D044963:Biopsy, Fine-Needle; D006528:Carcinoma, Hepatocellular / Q000473:pathology*; D003581:Cytodiagnosis; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood / Q000473:pathology; D008168:Lung / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis / Q000473:pathology; D009915:Orbit / Q000473:pathology; D010307:Parotid Neoplasms / Q000473:pathology* / Q000556:secondary; D012886:Skull / Q000473:pathology; D000509:alpha-Fetoproteins / Q000032:analysis
chemical_list: D000509:alpha-Fetoproteins