title: Solitary metastasis to the intercostal muscle from hepatocellular carcinoma: A case report.
abstract: BACKGROUND
  Skeletal muscle metastases from carcinomas, especially to intercostal muscles, are rare. Most metastatic chest wall tumors from hepatocellular carcinoma (HCC) result from disseminations through needle tracts of intrahepatic HCC treatments.
  
  
  METHODS
  We report the case of a 65-year-old man with chronic viral hepatitis B whose intrahepatic lesions were stabilized by repeated radiofrequency ablations and transcatheter arterial chemoembolization. Follow-up computed tomography demonstrated a well-enhanced mass in the right chest wall. Because α-fetoprotein and des-γ-carboxy prothrombin levels were elevated and no other tumors were detected, we diagnosed the mass as an extrahepatic metastasis from the HCC and resected it along with the surrounding ribs. There was no involvement of the bone, pleura, and lung.
  
  
  CONCLUSIONS
  The tumor was microscopically diagnosed as an intercostal muscle tumor metastasized from HCC, which has not been documented previously. The resection rate of extrahepatic tumors of HCC is low in literature. No other apparent extrahepatic recurrence has been observed for more than 20 months after the surgery.
  
  
  CONCLUSIONS
  We report the case of HCC patient who underwent surgical resection of an intercostal muscle tumor that had metastasized from HCC. Pathological examination of the tumor revealed the tumor cells in the blood vessels, and we speculate it hematogeneous metastasis.
authors.affiliation: Departments of Surgery, Kishiwada City Hospital, 1001 Gakuhara-cho, Kishiwada-shi, Osaka 596-8501, Japan.
authors.forename: Katsuyoshi
authors.initials: K
authors.lastname: Furumoto
authors.forename: Koki
authors.initials: K
authors.lastname: Miura
authors.forename: Daisuke
authors.initials: D
authors.lastname: Nagashima
authors.forename: Hidenobu
authors.initials: H
authors.lastname: Kojima
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Mori
authors.forename: Daisuke
authors.initials: D
authors.lastname: Ito
authors.forename: Kozo
authors.initials: K
authors.lastname: Kajimura
authors.forename: Masafumi
authors.initials: M
authors.lastname: Kogire