Solitary Bone Metastasis With Pathological Fracture : A Rare Atypical Presentation of HCC

Abstract

Hepatocellular carcinoma (HCC) is the most common primary malignancy of the liver which metastasizes by hematogenous and lymphatic routes commonly to the lungs & regional lymph nodes and rarely to the bones. In particular, symptomatic bone metastasis as a primary presentation in HCC is extremely rare. In this extremely rare case, the patient had no known liver disease, but presented with swelling and inability to lift his left arm. Core biopsy from left humerus was compatible with metastasis from adenocarcinoma in left humerus. Further investigations led to a diagnosis of hepatocellular carcinoma with solitary bone metastasis. It should be noted that if a patient has expansile osteolytic bone lesion, bone metastasis from HCC should be included in the differential diagnosis as a remote possibility.