title: Can hepatocellular carcinoma (HCC) produce unconventional metastases? Four cases of extrahepatic HCC.
abstract: OBJECTIVE
  Extrahepatic spread of hepatocellular carcinoma (HCC) diagnosed during the clinical course of the disease is not frequent; however, with the prolonged survival of HCC patients, the incidence of extrahepatic metastases seems to be increasing.
  
  
  METHODS
  We present four unusual cases of extrahepatic metastasis from HCC: the first concerns a patient who underwent a liver transplantation for HCC with cirrhosis and three years later developed metastases in the lung and the left orbit; the second is that of a patient who developed an extraperitoneal pararectal metastasis; in the third case a large osteolytic lesion developed on the left iliac bone, and in the fourth case we found an isolated metastasis in the left mandible.
  
  
  CONCLUSIONS
  These cases offer important information related to the unusual biology of isolated metastases from HCC after successful treatment of the primary cancer.
authors.affiliation: Deparment of Surgical Oncology, Hepatobiliary Surgery Unit, Istituto Nazionale per lo Studio e la Cura dei Tumori di Napoli, “Fondazione G Pascale”, Naples, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Piccirillo
authors.forename: Vincenza
authors.initials: V
authors.lastname: Granata
authors.forename: Vittorio
authors.initials: V
authors.lastname: Albino
authors.forename: Raffaele
authors.initials: R
authors.lastname: Palaia
authors.forename: Sergio Venanzio
authors.initials: SV
authors.lastname: Setola
authors.forename: Antonella
authors.initials: A
authors.lastname: Petrillo
authors.forename: Fabiana
authors.initials: F
authors.lastname: Tatangelo
authors.forename: Gerardo
authors.initials: G
authors.lastname: Botti
authors.forename: Margherita
authors.initials: M
authors.lastname: Foggia
authors.forename: Francesco
authors.initials: F
authors.lastname: Izzo
mesh_terms: D000368:Aged; D001859:Bone Neoplasms / Q000556:secondary*; D006528:Carcinoma, Hepatocellular / Q000556:secondary* / Q000601:surgery; D005260:Female; D006498:Hepatectomy; D006801:Humans; D007085:Ilium; D008113:Liver Neoplasms / Q000473:pathology* / Q000601:surgery; D008175:Lung Neoplasms / Q000556:secondary*; D008297:Male; D008339:Mandibular Neoplasms / Q000556:secondary*; D008875:Middle Aged; D009918:Orbital Neoplasms / Q000556:secondary; D014057:Tomography, X-Ray Computed