Brookdale University Hospital Medical Center, Brooklyn, NY, USA.
J Investig Med High Impact Case Rep. 2022 Jan-Dec;10:23247096221117788. doi: 10.1177/23247096221117788.
Hepatocellular carcinoma (HCC) is the most common primary hepatic cancer. Although it usually presents as a liver mass, rarely HCC can have an initial presentation at an extrahepatic site before the diagnosis of the primary lesion in the liver. Even rarely was that brain metastasis as initial extrahepatic presentations. Furthermore, the initial presentation of HCC as brain metastases has been with most cases being secondary to hepatitis-related hepatoma. In this case report, we are presenting a rare and unusual case of hemorrhagic cerebral metastasis as an initial extrahepatic presentation of an alcohol-related hepatoma. Our case is the second case in the English literature that has been presented in such a way. Due to the uncommonness of presentation, there can be diagnostic dilemmas and delay in treatment. Therefore, a high level of suspicion is needed in the high-risk patients of HCC who present with unexplained or new neurological signs and symptoms. More exploration is warranted for clinical research and treatment guidelines for brain metastases of HCC to help improve survival and quality of life.
肝细胞癌（HCC）是最常见的原发性肝癌。虽然它通常表现为肝脏肿块，但很少有 HCC 在诊断肝脏原发性病变之前首先出现在肝外部位。甚至更罕见的是脑转移作为最初的肝外表现。此外，HCC 的初始表现为脑转移，大多数情况下是继发于肝炎相关肝癌。在本病例报告中，我们报告了一个罕见且不寻常的病例，即酒精性肝癌以出血性脑转移为首发肝外表现。我们的病例是此类情况下在英文文献中报道的第二例。由于表现罕见，可能会出现诊断上的困境和治疗延误。因此，对于出现不明原因或新的神经系统症状和体征的 HCC 高危患者，需要高度怀疑。需要进行更多的临床研究和 HCC 脑转移的治疗指南探索，以帮助提高生存率和生活质量。
