Solitary skull metastasis as initial manifestation of hepatocellular carcinoma

Yu Shik Shim¹ , Jung Yong Ahn¹ , Jun Hyung Cho² and Kyu Sung Lee¹

¹Department of Neurosurgery, Yonsei Brain Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea

²Department of Neurosurgery, Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Republic of Korea

author email corresponding author email

World Journal of Surgical Oncology 2008, 6:66doi:10.1186/1477-7819-6-66


Published:	21 June 2008

Abstract

Background

A solitary skull metastasis from hepatocellular carcinoma (HCC) prior to diagnosis of the primary tumor without liver dysfunction is a very rare event.

Case presentation

A 71-year-old male, without known liver disease, presented to our institution with a palpable occipital scalp mass. On brain magnetic resonance imaging (MRI), a highly enhanced and osteolytic skull tumor was observed. The histological diagnosis obtained from the percutaneous needle biopsy was a cranial metastasis from HCC. The metastatic tumor was removed via occipital craniectomy, and the two primary liver mass lesions were subsequently treated by transarterial chemoembolization.

Conclusion

An isolated skull metastasis may be the sole initial presentation of HCC. Early diagnosis is essential in order to treat the primary disease. A skull metastasis from HCC should be considered in the differential diagnosis in patients with subcutaneous scalp mass and osteolytic defects on X-ray.