title: Lesion in Scalp and Skull as the First Manifestation of Hepatocellular Carcinoma.
abstract: Hepatocellular carcinoma (HCC) is the most common primary tumor of the liver and the fifth most common cancer in the world. The lungs, bone, and lymph nodes are frequent sites of metastasis of HCC. The purpose of the present study is show that metastases, although rare, must be among the differential diagnosis of skin lesions and that a diagnostic research based on these findings can be conducted. The authors report a rare case of metastatic hepatocellular injury to the scalp and skull treated by a radical surgical approach. Excision of the lesion in the scalp was performed "en bloc." The tumor was supplied by the frontal branch of the superficial temporal artery. There are few case reports of metastatic HCC to scalp and skull; treatment of these lesions should be individualized in order to control symptoms, improve quality of life, and promote an increase in survival.
authors.affiliation: Neurosurgery Residency Program, Discipline of Neurosurgery, Santa Casa de Sao Paulo School of Medical Sciences, Dr. Cesario Motta Jr. 112, 01220-000 Sao Paulo, SP, Brazil.
authors.forename: V R
authors.identifier: 0000-0003-4682-0664
authors.initials: VR
authors.lastname: Ferraz
authors.affiliation: Discipline of Neurosurgery, Santa Casa de Sao Paulo School of Medical Sciences and Arnaldo Vieira de Carvalho Cancer Institute, Dr. Cesario Motta Jr. 112, 01220-000 Sao Paulo, SP, Brazil.
authors.forename: J L
authors.initials: JL
authors.lastname: Vitorino-Araújo
authors.affiliation: Pathology Residency Program, Department of Pathology, Santa Casa de Sao Paulo School of Medical Sciences, Dr. Cesario Motta Jr. 112, 01220-000 Sao Paulo, SP, Brazil.
authors.forename: L
authors.identifier: 0000-0003-3790-6044
authors.initials: L
authors.lastname: Sementilli
authors.affiliation: Neurosurgery Residency Program, Discipline of Neurosurgery, Santa Casa de Sao Paulo School of Medical Sciences, Dr. Cesario Motta Jr. 112, 01220-000 Sao Paulo, SP, Brazil.
authors.forename: J F
authors.identifier: 0000-0002-2053-0485
authors.initials: JF
authors.lastname: Neto
authors.affiliation: Discipline of Neurosurgery, Santa Casa de Sao Paulo School of Medical Sciences and Arnaldo Vieira de Carvalho Cancer Institute, Dr. Cesario Motta Jr. 112, 01220-000 Sao Paulo, SP, Brazil.
authors.forename: J C E
authors.initials: JC
authors.lastname: Veiga