Soto S, Artaza T, Gomez R, Camacho F I, Rodriguez I, Gonzalez C, Potenciano J L, Rodriguez R
Dept. of Gastroenterology, Hospital Virgen de la Salud, Toledo, Spain.
Scand J Gastroenterol. 2000 Mar;35(3):333-6. doi: 10.1080/003655200750024245.
Bone metastasis infrequently appears as the first manifestation of hepatocellular calcinoma (HCC), and in any case in most patients the primary tumour is detected a few months after its development. We report the case of a patient with alcoholic liver disease, increased levels of alpha-fetoprotein, and no evidence of hepatic lesion in the different imaging modalities, in whom metastasis of HCC was detected in the ribs, whereas the primary tumour was not diagnosed until 15 months later. We believe that all patients with increased levels of alpha-fetoprotein should be tested in an intensified search for HCC and possible metastases, given that hepatic lesions may not be detected until many months alter the diagnosis of metastatic disease.
骨转移很少作为肝细胞癌（HCC）的首发表现出现，而且在大多数情况下，大多数患者在原发肿瘤发生几个月后才被检测到。我们报告了一例患有酒精性肝病、甲胎蛋白水平升高且在不同影像学检查中均未发现肝脏病变证据的患者，该患者在肋骨中检测到HCC转移，而原发肿瘤直到15个月后才被诊断出来。我们认为，鉴于在转移性疾病诊断后数月才可能检测到肝脏病变，所有甲胎蛋白水平升高的患者都应接受强化检查以寻找HCC及可能的转移灶。
