A case of well-differentiated minute hepatocellular carcinoma with extrahepatic metastasis

ABSTRACT A rare case of well‐differentiated minute hepatocellular carcinoma (HCC) metastasizing to distant sites in a 77‐year‐old man with hepatitis C virus (HCV)‐related cirrhosis is presented. Ultrasonography (US) disclosed a 9 mm hypoechoic lesion in segment seven (S7) of the liver, although comp...

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Published in:Journal of gastroenterology and hepatology 1998-09, Vol.13 (9), p.892-896
Main Authors: KIM, SOO RYANG, HAYASHI, YOSHITAKE, MATSUOKA, TOSHIYUKI, PARK, SOK YONG, SHINTANI, SHIGEYUKI, SASAKI, KAZUNORI, ASANO, JUN, KIM, JUNG HYO, KIM, KE IH, IMOTO, SUSUMU, ITOH, HIROSHI, KUDO, MASATOSHI
Format: Article
Language:English
Subjects:
Aged
alpha-Fetoproteins - genetics
Biological and medical sciences
Carcinoma, Hepatocellular - blood
Carcinoma, Hepatocellular - pathology
Carcinoma, Hepatocellular - secondary
distant metastasis
Gastroenterology. Liver. Pancreas. Abdomen
Humans
Liver Neoplasms - blood
Liver Neoplasms - pathology
Liver. Biliary tract. Portal circulation. Exocrine pancreas
Male
Medical sciences
RNA, Messenger - blood
Tumors
ultrasonography
well-differentiated minute hepatocellular carcinoma
α-fetoprotein-mRNA
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Summary:ABSTRACT A rare case of well‐differentiated minute hepatocellular carcinoma (HCC) metastasizing to distant sites in a 77‐year‐old man with hepatitis C virus (HCV)‐related cirrhosis is presented. Ultrasonography (US) disclosed a 9 mm hypoechoic lesion in segment seven (S7) of the liver, although computed tomography (CT), magnetic resonance imaging (MRI) and angiography did not reveal any space‐occupying lesion. Ultrasound‐guided biopsy showed the histological features of well‐differentiated HCC. A plain film of the abdomen and CT revealed osteolytic changes in the sacrum and the lumbar vertebra. Ultrasound‐guided biopsy of the sacrum revealed well‐to‐moderately differentiated HCC metastasizing from the liver. Percutaneous ethanol injection therapy (PEIT) effected complete response and completely eliminated the abnormal findings on US. Three months after PEIT, metastasis to the thoracic vertebra was revealed by CT, despite negative α‐fetoprotein‐mRNA in serum. This is the first report describing a well‐differentiated HCC with metastatic potential. Further studies may provide insights into metastasis of well‐differentiated HCC.
ISSN:0815-9319
1440-1746
DOI:10.1111/j.1440-1746.1998.tb00757.x