Open AccessEvaluation of bone metastasis as the first presentation of hepatocellular carcinoma using 18-fluorodeoxyglucose positron emission tomography-computed tomography
Author(s) -
Arif Kürşad Ayan,
Bedri Seven,
Ebru Örsal,
Elif Demirci
Publication year - 2013
Publication title -
indian journal of nuclear medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.261
H-Index - 13
eISSN - 0972-3919
pISSN - 0974-0244
DOI - 10.4103/0972-3919.119552
Subject(s) - medicine , hepatocellular carcinoma , radiology , rib cage , bone metastasis , metastasis , differential diagnosis , positron emission tomography , bone marrow , biopsy , femur , pathology , axial skeleton , abdomen , cancer , anatomy , surgery , cancer research
We report a case of a patient with hepatocellular carcinoma (HCC) who presented with back pain related to bone metastasis. HCC metastasizes by hematogenous and lymphatic routes commonly to the lungs, regional lymph nodes, kidney, bone marrow and adrenals. In this extremely rare case, the patient had no known liver disease, but presented with liver lesions and multiple bone lesions involving vertebrae, ribs, pelvic bones and left femur with associated expansile soft-tissue components. These bone lesions were first detected from a positron emission tomography scan. Pathological examination of biopsy material taken from the left eighth rib confirmed metastatic HCC. In conclusion, if a patient has expansile osteolytic bone lesions, bone metastasis from HCC should be included in the differential diagnosis.