Selcuk University, Meram Faculty of Medicine, Department of Radiation Oncology, Konya, Turkey.
Radiol Oncol. 2011 Dec;45(4):292-5. doi: 10.2478/v10019-011-0022-7. Epub 2011 Jul 20.
The majority of subcutaneous metastases from hepatocellular carcinoma (HCC) originate from needle tracks or surgical wound contamination. Non-iatrogenic subcutaneous metastasis from hepatocellular carcinoma was rarely reported.
A 70-year-old man presented with a mass in his left occipital region of the scalp. The surgical complete resection was performed. The histopathology report of the scalp mass showed a characteristic metastatic HCC. Computed tomography (CT) of the abdomen showed no primary or metastatic lesion in the abdomen; that's why the adjuvant treatment was not given after the surgery. Five months later, magnetic resonance imaging (MRI) of the brain revealed a 6 × 5.5 cm mass at the left posterior parietal region of the scalp. Second surgery was performed and histopathology of the specimen excised was again metastatic HCC. The external beam radiation therapy (XRT) was administered after the surgery. A follow-up MRI of the brain showed no recurrent disease after 9 months from XRT.
HCCs should be considered in the differential diagnosis of carcinomas metastatic to the skin, even in the absence of liver symptoms.
大多数来自肝细胞癌 (HCC) 的皮下转移源自于针道或手术伤口污染。非医源性肝细胞癌皮下转移则很少见。
一名 70 岁男性患者因头皮左枕部肿块就诊。肿块行完整切除术。头皮肿块的组织病理学报告显示为特征性转移性 HCC。腹部 CT 未显示腹部有原发性或转移性病变；因此，手术后未给予辅助治疗。五个月后，脑部磁共振成像 (MRI) 显示头皮左顶后区有一个 6×5.5cm 的肿块。再次行手术，切除标本的组织病理学再次为转移性 HCC。手术后行外照射放疗 (XRT)。XRT 后 9 个月行脑部 MRI 随访未见疾病复发。
即使没有肝脏症状，在皮肤癌转移的鉴别诊断中也应考虑 HCC。
