Department of Internal Medicine, Midnapore Medical College and Hospital, Midnapore, WB, India.
Department of Internal Medicine, RG Kar Medical College and Hospital, Kolkata, India.
J R Coll Physicians Edinb. 2024 Sep;54(3):221-224. doi: 10.1177/14782715241270368. Epub 2024 Aug 13.
Hepatocellular carcinoma (HCC) is the most common primary malignancy of the liver, among which around 18-64% metastasize, most frequently to lungs, regional lymph nodes and adrenal glands. Metastasis of HCC to the central nervous system represents a rare yet clinically significant phenomenon, often presenting diagnostic and therapeutic challenges. In this case report, we document a 35-year-old male who presented with a secondary headache and right ophthalmoplegia attributable to metastatic deposits secondary to HCC infiltrating the cavernous sinus and superior orbital fissure. Despite therapeutic interventions including local palliative radiotherapy and sorafenib, the patient succumbed to acute liver failure after 9 months. This case highlights the aggressive potential of HCC to involve the central nervous system and the importance of heightened clinical suspicion for early diagnosis and intervention in such rare but clinically impactful scenarios.
肝细胞癌（HCC）是肝脏最常见的原发性恶性肿瘤，其中约 18-64%发生转移，最常转移至肺部、局部淋巴结和肾上腺。HCC 转移至中枢神经系统是一种罕见但具有临床意义的现象，常带来诊断和治疗方面的挑战。在本病例报告中，我们记录了一名 35 岁男性患者，因 HCC 侵犯海绵窦和眶上裂而继发转移灶，表现为继发性头痛和右眼外肌麻痹。尽管进行了包括局部姑息性放疗和索拉非尼在内的治疗干预，但该患者在 9 个月后因急性肝功能衰竭而死亡。本病例强调了 HCC 侵犯中枢神经系统的侵袭性潜力，以及在这种罕见但具有临床影响的情况下，提高临床警惕以早期诊断和干预的重要性。
