[An atypical bone metastasis of hepatocellular carcinoma: case report and review of the literature].
Bone metastases are a quite frequent complication of hepatocellular carcinoma (HCC). They are a substantial fraction (about 14-28%) of the metastatic locations of this neoplasm. Recent studies are indicative of the clinical usefulness of local therapy of HCC bone metastasis, expecially if they are single locations. The presence of a single bone metastasis does not seem to influence short term prognosis of the primary neoplasm and, furthermore, its treatment by radiation, chemio-embolization or surgery may obtain long-term pain control, without the side effects of analgesic drugs. Most frequently, bone metastases of HCC appear in the spine, femur, humerus or ribs. In the last years, some atypical locations, as jaws, gums and skull, were reported. In this paper, we report the case of a painful bone metastasis of HCC, localized at the second phalanx of the second finger of the right hand. To our knowledge, until now only two cases of HCC metastatic location at the bones of the hand have been reported. The lesion has been treated by surgical ablation, obtaining long-term pain remission and the withdrawal of the analgesic drugs. Few weeks later, another bone metastasis appeared, located at the second phalanx of the third finger of the same hand, indicating in this subject a peculiar "metastatic tropism".
Fontana
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Istituto di Patologia Speciale Medica e Semeiotica Medica, Facoltà di Medicina e Chirurgia, Università Cattolica del Sacro Cuore, Roma, Italia.
Siciliano
M
M
Franceschelli
A
A
Annicchiarico
B E
BE
Rossi
P
P
Bigotti
G
G
Bombardieri
G
G
D001859:Bone Neoplasms / Q000556:secondary*; D006528:Carcinoma, Hepatocellular / Q000556:secondary*; D005385:Fingers; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology*; D008297:Male; D008875:Middle Aged