title: Muscle metastasis from hepatocellular carcinoma.
abstract: BACKGROUND
  Hepatocellular carcinoma is the most common primary tumor of the liver. Disease dissemination occurs through hematogenous routes and frequently involves the lungs, bone, adrenal glands, and pancreas. The patterns of the extrahepatic manifestations are diverse. Soft tissue metastasis is extremely rare and mandates systematic pathological analysis, which may include the use of specific immunohistochemical staining. We report metastasis from a hepatocellular carcinoma, as a discrete subcutaneous mass to the right humerus muscle.
  
  
  METHODS
  We detail the approach to diagnosis and management of an unusual case of a patient with hepatocellular carcinoma, in whom we found a metastatic lesion as a subcutaneous mass to the right humerus muscle nine years after right hepatectomy.
  
  
  CONCLUSIONS
  This condition poses differential diagnostic problems in the settings of clinical and pathological investigations. Metastasis of hepatocellular carcinoma should be included in the differential diagnosis of rapidly growing lesions.
authors.affiliation: Radiology Department, Aretaieion University Hospital, University of Athens, Athens, Greece.
authors.forename: Vasiliki
authors.initials: V
authors.lastname: Michalaki
authors.forename: Anna
authors.initials: A
authors.lastname: Zygogianni
authors.forename: Vassilios
authors.initials: V
authors.lastname: Kouloulias
authors.forename: Myrsini
authors.initials: M
authors.lastname: Balafouta
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Vlachodimitropoulos
authors.forename: Constantine G
authors.initials: CG
authors.lastname: Gennatas
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000473:pathology* / Q000601:surgery; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology* / Q000601:surgery; D008297:Male; D019042:Muscle Neoplasms / Q000556:secondary* / Q000601:surgery; D011379:Prognosis