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A case of well‐differentiated minute hepatocellular carcinoma with extrahepatic metastasis
Author(s) -
KIM SOO RYANG,
HAYASHI YOSHITAKE,
MATSUOKA TOSHIYUKI,
PARK SOK YONG,
SHINTANI SHIGEYUKI,
SASAKI KAZUNORI,
ASANO JUN,
KIM JUNG HYO,
KIM KE IH,
IMOTO SUSUMU,
ITOH HIROSHI,
KUDO MASATOSHI
Publication year - 1998
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/j.1440-1746.1998.tb00757.x
Subject(s) - medicine , hepatocellular carcinoma , radiology , metastasis , cirrhosis , biopsy , abdomen , lesion , bone metastasis , pathology , magnetic resonance imaging , vertebra , percutaneous ethanol injection , cancer , anatomy , ablation , radiofrequency ablation
A rare case of well‐differentiated minute hepatocellular carcinoma (HCC) metastasizing to distant sites in a 77‐year‐old man with hepatitis C virus (HCV)‐related cirrhosis is presented. Ultrasonography (US) disclosed a 9 mm hypoechoic lesion in segment seven (S 7 ) of the liver, although computed tomography (CT), magnetic resonance imaging (MRI) and angiography did not reveal any space‐occupying lesion. Ultrasound‐guided biopsy showed the histological features of well‐differentiated HCC. A plain film of the abdomen and CT revealed osteolytic changes in the sacrum and the lumbar vertebra. Ultrasound‐guided biopsy of the sacrum revealed well‐to‐moderately differentiated HCC metastasizing from the liver. Percutaneous ethanol injection therapy (PEIT) effected complete response and completely eliminated the abnormal findings on US. Three months after PEIT, metastasis to the thoracic vertebra was revealed by CT, despite negative α‐fetoprotein‐mRNA in serum. This is the first report describing a well‐differentiated HCC with metastatic potential. Further studies may provide insights into metastasis of well‐differentiated HCC.