Haematogenous abdominal wall metastasis of differentiated, alpha-fetoprotein-negative hepatocellular carcinoma after previous antiandrogen therapy within a site of lipoma manifestation since childhood.
BACKGROUND
Cases with subcutaneous metastasis of differentiated hepatocellular carcinoma to the abdominal wall without prior seeding as a consequence of local interventions with a negative or normal alpha-fetoprotein level in the serum are extremely rare.


METHODS
This is the first report of a case with AFP-negative, differentiated hepatocellular carcinoma metastasis to the abdominal wall within a pre-existing subcutaneous lipoma since childhood after antiandrogen therapy with leuprorelin and buserelin acetate for prostate cancer without seeding.


METHODS
Clinical features including histology, immunohistochemistry, clinical course and surgical approach are presented.


RESULTS
Histological examination revealed a hepatocellular carcinoma with a trabecular and pseudoglandular growth pattern with moderately atypical hepatocytes with multifocal bile formation within a lipoma. The postoperative course of abdominal wall reconstruction with a monocryl-prolene mesh and a local flap after potentially curative resection was uncomplicated.


CONCLUSIONS
It may be that previous antiandrogen treatment for prostate carcinoma contributed to the fact that our patient developed alpha-fetoprotein-negative and androgen receptor-negative subcutaneous abdominal wall metastasis within a pre-existing lipoma since childhood.
General, Visceral und Transplantation Surgery, Hanover Medical School, Carl-Neuberg-Str, 1, 30625, Hannover, Germany.
L
L
Zachau
C
C
Zeckey
J
J
Schlue
J
J
Sander
C
C
Meyer-Heithuis
M
M
Winkler
J
J
Klempnauer
H
H
Schrem
D000008:Abdominal Neoplasms / Q000139:chemically induced / Q000378:metabolism / Q000556:secondary* / Q000601:surgery; D034861:Abdominal Wall / Q000473:pathology* / Q000601:surgery; D000368:Aged; D000726:Androgen Antagonists / Q000009:adverse effects*; D006528:Carcinoma, Hepatocellular / Q000139:chemically induced / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D002454:Cell Differentiation; D002648:Child; D006801:Humans; D008067:Lipoma / Q000139:chemically induced* / Q000473:pathology / Q000601:surgery; D008113:Liver Neoplasms / Q000139:chemically induced / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D008297:Male; D009367:Neoplasm Staging; D011379:Prognosis; D011471:Prostatic Neoplasms / Q000188:drug therapy; D000509:alpha-Fetoproteins / Q000378:metabolism*
D000726:Androgen Antagonists; D000509:alpha-Fetoproteins