title: [Skull metastasis of hepatocellular carcinoma: case report].
abstract: We report a case of skull metastasis from a hepatocellular carcinoma (HCC). A 68-year-old male with hepatitis C virus-associated cirrhosis and HCC presented with painless subcutaneous mass in the left frontotemporal region. Radiologically, skull X-ray showed an osteolytic lesion, and non-contrast CT displayed a hyperdense tumor that homogeneously enhanced on contrast CT. Cerebral angiography demonstrated a hypervascular mass with the feeding arteries from the external carotid artery. The tumor was shown as an iso-intensity mass with flow voids on T1WI, as iso- to hypo- intensity on T2WI and FLAIR images, and as hypo-intensity on DWI. The lesion was markedly enhanced by Gd-DTPA. Previous reports have described a low incidence of skull metastasis in HCC patients. However, the incidence is gradually increasing due to the prolonged survival rates of HCC patients, indicating the significance of the disease as a differencial diagnosis for skull tumors. Recent reports describe characteristic MRI findings of skull metastasis from HCC (hypointensity on T2WI with flow void); however, owing to the rarity of this disease, more studies are needed to establish the typical MRI pathognomonic findings.
authors.affiliation: Department of Neurosurgery, Nagasaki Rousai Hospital, Japan. i-kwhr@net.nagasaki-u.ac.jp
authors.forename: Ichiro
authors.initials: I
authors.lastname: Kawahara
authors.forename: Keisuke
authors.initials: K
authors.lastname: Tsutsumi
authors.forename: Makoto
authors.initials: M
authors.lastname: Hirose
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Matsuo
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Yokoyama
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000473:pathology / Q000556:secondary*; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology*; D008297:Male; D012888:Skull Neoplasms / Q000175:diagnosis / Q000556:secondary*