Song Qi, Sun Xiao-Feng, Wu Xiao-Li, Dong Yi, Wang Le
Department of Ultrasound, Bethune First Hospital of Jilin University, Changchun 130000, Jilin Province, China.
World J Clin Cases. 2021 May 16;9(14):3334-3341. doi: 10.12998/wjcc.v9.i14.3334.
The metastasis of liver cancer to skeletal muscle is extremely rare compared to other sites. We herein report a case of rapidly developing skeletal metastases following liver transplantation due to primary liver cancer.
A 70-year-old male with underlying chronic hepatitis B virus infection was diagnosed with hepatocellular carcinoma (HCC), for which he underwent liver transplantation in 2014. Six years after receiving the transplant, pathological examination confirmed the presence of HCC without vascular invasion. He was admitted to the hospital with a rapidly growing mass on his right thigh. Ultrasound examination revealed a mixed echo mass in the lateral soft tissue of the middle part of the right femur. Magnetic resonance imaging showed heterogeneous iso-signal intensity on T1-weighted images and heterogeneous hyper-intensity on T2-weighted images compared to the surrounding muscles. Pathological examination of the ultrasound-guided needle biopsy specimen revealed that it was similar to the previously detected liver cancer; the diagnosis was metastasis of HCC. Surgical excision was performed. There were no other sites of metastasis, and the patient recovered well after surgery.
This report presents a rare case of skeletal metastasis following liver transplantation for HCC. The study suggests a possible role for skeletal muscle metastasis mechanisms, which should be the focus of future research.
与其他部位相比，肝癌转移至骨骼肌极为罕见。我们在此报告一例因原发性肝癌肝移植后迅速发生骨转移的病例。
一名70岁男性，患有慢性乙型肝炎病毒感染，被诊断为肝细胞癌（HCC），于2014年接受肝移植。移植后六年，病理检查证实存在无血管侵犯的HCC。他因右大腿迅速增大的肿块入院。超声检查显示右股骨中部外侧软组织有混合回声肿块。磁共振成像显示，与周围肌肉相比，T1加权图像上呈不均匀等信号强度，T2加权图像上呈不均匀高信号强度。超声引导下针吸活检标本的病理检查显示，其与先前检测到的肝癌相似；诊断为HCC转移。进行了手术切除。无其他转移部位，患者术后恢复良好。
本报告介绍了一例HCC肝移植后罕见的骨转移病例。该研究提示了骨骼肌转移机制可能发挥的作用，这应成为未来研究的重点。
