A case of well-differentiated minute hepatocellular carcinoma with extrahepatic metastasis |
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| Authors: | SOO RYANG KIM YOSHITAKE HAYASHI TOSHIYUKI MATSUOKA SOK YONG PARK SHIGEYUKI SHINTANI KAZUNORI SASAKI JUN ASANO JUNG HYO KIM KE IH KIM SUSUMU IMOTO HIROSHI ITOH MASATOSHI KUDO |
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| Affiliation: | *Department of Gastroenterology, Kobe Asahi Hospital, Kobe, Japan;§Department of Pharmacy, Kobe Asahi Hospital, Kobe, Japan;†1st Department of Pathology, Kobe University, Kobe, Japan;‡Department of Radiology, Osaka City University, Osaka, Japan;#Department of 2nd Internal Medicine, Kinki University, Osaka, Japan |
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| 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. |
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| Keywords: | distant metastasis, α-fetoprotein-mRNA, ultrasonography, well-differentiated minute hepatocellular carcinoma. |
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