Necrotizing myelopathy associated with hepatocellular carcinoma.

A 43-year-old Japanese male with hepatocellular carcinoma suddenly developed paraplegia. The spinal cord signs first progressed rapidly but then gradually subsided. The patient died of hepatic failure ten months later. The autopsy disclosed cavitation and softening of the spinal cord from the level of C6 to T10, a characteristic of necrotizing myelopathy. Neither local nor apparent systemic causes to explain the spinal cord lesion were disclosed at the autopsy. This seems to be the first documented rare paraneoplastic syndrome, associated with hepatocellular carcinoma.