Abstract
A 49-year-old woman presented with severe swelling and pain of the left little finger, which had exacerbated rapidly, in October 2006. The patient had a history of hepatocellular carcinoma and metastatic lung cancer. She had undergone partial hepatectomy for the hepatocellular carcinoma in September 2001 and pulmonary resection for metastatic lung cancer in November 2005. Roentgenogram of the hand on admission showed complete destruction of the distal phalanx of the left little finger. The final pathological result of the tissue obtained by disarticulation was an extrahepatic metastasis of hepatocellular carcinoma. Extrahepatic metastasis from primary hepatocellular carcinoma to the hand is very rare and only four cases have been reported in the literature. All the patients with extrahepatic metastases from the primary hepatocellular carcinoma to the hand had poor prognoses, but the patient presented in this article exhibited an unusual clinical course. The patient is still alive 1 year after the diagnosis of extrahepatic bone metastasis of the distal phalanx.
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References
Reichbach EJ, Levinson JD, Fagin RR (1970) Unusual osseous metastases of hepatoma. JAMA 213:2078–2079
Delsmann BM, Lienemann A, Nerlich A, et al. (1998) Primary manifestation of hepatocellular carcinoma as osteolytic hand metastasis — a case report. Z Orthop Ihre Grenzgeb 136:571–573
Lee KS, Lee SH, Kang KH, et al. (1999) Metastatic hepatocellular carcinoma of the distal phalanx of the thumb. Hand Surg 4:95–100
Fontana T, Siciliano M, Franceschelli A, et al. (2004) An atypical bone metastasis of hepatocellular carcinoma: case report and review of the literature. Clin Ter 155:447–451
Katyal S, Oliver JH 3rd, Peterson MS, et al. (2000) Extrahepatic metastases of hepatocellular carcinoma. Radiology 216:698–703
The Liver Cancer Study Group of Japan (1989) Primary liver cancer in Japan. Cancer 54:1747–1755
Si MS, Amersi F, Golish SR, et al. (1999) Prevalence of metastases from hepatocellular carcinoma. Hepatogastroenterology 46:1049–1052
Shuto T, Hirohashi K, Kudo S, et al. (2003) Treatment of adrenal metastases after hepatic resection of a hepatocellular carcinoma. Dig Surg 18:294–297
Uka K, Aikata H, Takaki S, et al. (2007) Clinical features and prognosis of patients with extrahepatic metastases from hepatocellular carcinoma. World J Gastroenterol 21:414–420
Natsuizaka M, Omura T, Akaike T, et al. (2005) Clinical features of hepatocellular carcinoma with extrahepatic metastases. J Gastroenterol Hepatol 20:1781–1787
Yeu-Tsu MI, Geer DA (1987) Primary liver cancer: pattern of metastasis. J Surg Oncol 36:26–31
Inagaki Y, Unoura M, Urabe T, et al. (1993) Distant metastases of hepatocellular carcinoma after successful treatment of the primary lesion. Hepatogastroenterology 40:316–319
Nakashima T, Okuda K, Kojiro M, et al. (1983) Pathology of hepatocellular carcinoma in Japan. Cancer 51:863–877
Okazaki N, Yoshino M, Yoshida T, et al. (1985) Bone metastasis in hepatocellular carcinoma. Cancer 55:1991–1994
Fukusato T, Aoyama H, Mori W (1989) Age and sex differences in bone metastasis of hepatocellular carcinoma in Japanese autopsy cases. Gastroenterol Jpn 24:127–134
Taki Y, Yamaoka Y, Takayasu T, et al. (1992) Bone metastases of hepatocellular carcinoma after liver resection. J Surg Oncol 50:12–18
Kuhlman JE, Fishman EK, Leichner PK, et al. (1986) Skeletal metastasis from hepatoma: frequency, distribution and radiographic features. Radiology 160:175–178
Kay RM, Eckardt JJ, Goldstein LI, et al. (1994) Metastatic hepatocellular carcinoma to the bone in a liver transplant patient: a case report. Clin Orthop Relat Res 303:237–241
Gattuso P, Reyes CV (1988) Hepatocellular carcinoma with bone metastasis. J Surg Oncol 39:33–34
Liaw CC, Ng KT, Chen TJ, et al. (1989) Hepatocellular carcinoma presenting as bone metastasis. Cancer 64:1753–1757
Galmarti CM, Kertesz A, Oliva R, et al. (1998) Metastasis of bronchogenic carcinoma to the thumb. Med Oncol 15:282–285
Carvalho Hde A, Tsai PW, Takagaki TY (2002) Thumb metastasis from small cell lung cancer treated with radiation. Rev Hosp Clin Fac Med Sao Paulo 57:283–286
Okuda K, Ohtsuki T, Obata H, et al. (1985) Natural history of hepatocellular carcinoma and prognosis in relation to treatment. Cancer 56:918–928
Poon RT, Fan ST, O’suilleabhain CB, et al. (2002) Aggressive management of patients with extrahepatic and intrahepatic recurrence of hepatocellular carcinoma by combined resection and locoregional therapy. J Am Coll Surg 195:311–318
Lo CM, Lai EC, Fan ST, et al. (1994) Resection for extrahepatic recurrence of hepatocellular carcinoma. Br J Surg 81:1019–1021
Lam CM, Lo CM, Yuen WK, et al. (1998) Prolonged survival in selected patients following surgical resection for pulmonary metastases from hepatocellular carcinoma. Br J Surg 85:1198–1120
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Otsuji, M., Matsunaga, S., Koga, H. et al. An atypical extrahepatic metastasis of the distal phalanx from hepatocellular carcinoma. Int J Clin Oncol 14, 159–162 (2009). https://doi.org/10.1007/s10147-008-0806-y
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DOI: https://doi.org/10.1007/s10147-008-0806-y