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CC BY 4.0 · World J Nucl Med 2023; 22(01): 055-058
DOI: 10.1055/s-0042-1757288
Case Report

Metastatic Hepatocellular Carcinoma Masquerading as an Expansile Osteolytic Lesion in Scapula: A Rare Case of Isolated Appendicular Skeletal Metastatic Involvement of Hepatocellular Carcinoma at Initial Presentation

Arun Ravi John 
1   Department of Nuclear Medicine, Command Hospital Air Force, Bengaluru, Karnataka, India
,
Surjeet Dwivedi
2   Department of Surgical Oncology, Command Hospital Air Force, Bengaluru, Karnataka, India
,
Jeenu Varghese
3   Department of Pathology, Command Hospital Air Force, Bengaluru, Karnataka, India
,
Gurpreet Kaur Walia
3   Department of Pathology, Command Hospital Air Force, Bengaluru, Karnataka, India
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Abstract

Hepatocellular carcinoma (HCC) is known to be the most common primary tumor of the liver and is also the fifth most common cancer in the world. Chronic hepatitis B and C along with type 2 diabetes mellitus and alcoholic liver disease are quite well-known risk factors for HCC, and it is uncommon in the noncirrhotic liver. HCC favors spreading as multifocal intrahepatic lesions and potential vascular invasion, and extrahepatic spread is uncommon. Skeletal metastasis from HCC occurs infrequently compared to other cancers and is common in the axial skeleton. Metastatic involvement of the appendicular skeleton is a rare entity, and the initial presentation of HCC as metastatic involvement of the appendicular skeleton is even rarer. We report a case of HCC with incidentally detected cirrhosis and chronic hepatitis B infection presenting with pain in the left shoulder.

Keywords

appendicular skeletal metastasis - chronic Hepatitis B - FDG PET-CT - hepatocellular carcinoma - triple phase CECT

Authors' Contributions

Arun Ravi John contributed to manuscript preparation, Surjeet Dwivedi contributed to reviewing of manuscript, Jeenu Varghese contributed to manuscript preparation and histopathological image preparation, and Gurpreet Kaur Walia contributed to reviewing the manuscript including histopathology report. The manuscript has been read and approved by all the authors, the requirements for authorship as stated earlier in this document have been met, and each author believes that the manuscript represents honest work.




Publication History

Article published online:
31 October 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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