title: An atypical extrahepatic metastasis of the distal phalanx from hepatocellular carcinoma.
abstract: A 49-year-old woman presented with severe swelling and pain of the left little finger, which had exacerbated rapidly, in October 2006. The patient had a history of hepatocellular carcinoma and metastatic lung cancer. She had undergone partial hepatectomy for the hepatocellular carcinoma in September 2001 and pulmonary resection for metastatic lung cancer in November 2005. Roentgenogram of the hand on admission showed complete destruction of the distal phalanx of the left little finger. The final pathological result of the tissue obtained by disarticulation was an extrahepatic metastasis of hepatocellular carcinoma. Extrahepatic metastasis from primary hepatocellular carcinoma to the hand is very rare and only four cases have been reported in the literature. All the patients with extrahepatic metastases from the primary hepatocellular carcinoma to the hand had poor prognoses, but the patient presented in this article exhibited an unusual clinical course. The patient is still alive 1 year after the diagnosis of extrahepatic bone metastasis of the distal phalanx.
authors.affiliation: Department of Orthopaedic Surgery, Imakiire General Hospital, 4-16 Shimotatsuo-cho, Kagoshima, 892-8502, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Otsuji
authors.forename: Shunji
authors.initials: S
authors.lastname: Matsunaga
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Koga
authors.forename: Naoya
authors.initials: N
authors.lastname: Kawabata
authors.forename: Takanori
authors.initials: T
authors.lastname: Imakiire
authors.forename: Takuya
authors.initials: T
authors.lastname: Hiwaki
authors.forename: Yukie
authors.initials: Y
authors.lastname: Tashiro
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Shirahama
authors.forename: Setsuro
authors.initials: S
authors.lastname: Komiya
mesh_terms: D001859:Bone Neoplasms / Q000175:diagnosis / Q000556:secondary*; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology*; D005260:Female; D050278:Finger Phalanges; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology*; D008175:Lung Neoplasms / Q000556:secondary; D008875:Middle Aged; D015996:Survival Rate