Lee Gk, Lorenz Hp, Mohan Sv
Stanford University, California, USA.
J Surg Case Rep. 2010 Jun 1;2010(4):3. doi: 10.1093/jscr/2010.4.3.
Hepatocellular carcinoma most often metastasizes to the lungs, abdominal lymph nodes, or bone. The identification of extrahepatic metastases of hepatocellular carcinoma to the sinonasal region has rarely been reported. We report a case of a 49 year-old man with a history of stage IV hepatocellular carcinoma presenting with two adjacent pigmented lesions on the tip of his nose. Initial pathological staining identified the lesion as a primary melanoma. However, upon further examination with the chemical markers CEA, CAM 5.2, and Keratin, it was determined that the lesions were consistent with hepatocellular carcinoma. This case highlights a potentially rare situation of mistaking a liver metastasis for a malignant melanoma.
肝细胞癌最常转移至肺、腹部淋巴结或骨骼。肝细胞癌肝外转移至鼻窦区域的情况鲜有报道。我们报告一例49岁男性病例，该患者有IV期肝细胞癌病史，鼻尖出现两个相邻的色素沉着病变。最初的病理染色将病变确定为原发性黑色素瘤。然而，进一步使用癌胚抗原（CEA）、细胞角蛋白5.2（CAM 5.2）和角蛋白等化学标志物检查后，确定这些病变符合肝细胞癌。该病例凸显了一种可能罕见的情况，即将肝转移误诊为恶性黑色素瘤。
