[A case of hepatocellular carcinoma treated by resection of metachronous rib metastasis after primary hepatectomy].

A 76-year-old man underwent right hemihepatectomy and partial hepatectomy of segment II for hepatocellular carcinoma (HCC) at our institution. Four months after the primary hepatectomy, the patient complained of severe back pain on the right side, and computed tomography and bone scintigraphy indicated metastasis of the eighth rib on the right side. Because no metastatic lesions were observed in any organ, the patient underwent surgical intervention for the rib metastasis in December 2011. Histopathological findings confirmed that the metastatic tumor originated from the HCC and that cancer tissues were absent from the surgical margins. Postoperative radiotherapy was additionally performed for preventing local recurrence. The sharp cancerous pain disappeared completely, and the patient was lived without recurrence 6 months after the second surgery. In cases where intrahepatic or other metastatic lesions are controllable and only a solitary bone metastatic lesion is evident, surgical resection is effective in HCC patients with bone metastasis.