Hepatocellular carcinoma presenting as rapidly growing sternal mass: an unusual presentation

Hepatocellular carcinoma presenting as rapidly growing sternal mass: an unusual presentation Rahul S. Kulkarni, Asha S. Anand, Apurva A. Patel, Sandip A. Shah Department of Medical and Paediatric Oncology, Gujarat Cancer Research Institute, Ahmedabad 380016, Gujarat, India. Correspondence to: Dr. Rahul S. Kulkarni, Department of Medical and Paediatric Oncology, Gujarat Cancer Research Institute, Ahmedabad 380001, Gujarat, India. E-mail: dr.rsk08@gmail.com Hepatocellular carcinoma (HCC) is the most common malignant tumor of the liver. The most frequent sites of metastases are lungs, regional lymph nodes, adrenals and bones. However, an isolated sternal metastasis from HCC as an initial presentation has been rarely reported. A 45-year-old man presented with a progressively increasing mass over the anterior chest wall. On investigations, it was found to be arising from the sternum. Histopathology was suggestive of metastatic HCC, later confirmed by the presence of a 9 cm × 7 cm mass in the liver on abdominal computed tomography scan and a significantly elevated serum alpha fetoprotein level. Thus, metastasis from HCC should be included in the differential diagnosis of anterior chest wall mass and rapidly growing osseous metastases at unusual sites, even in the absence of signs of liver disease.