A resected case of solitary hematogenous chest-wall metastasis after surgery for hepatocellular carcinoma

Abstract

A 71-year-old woman, undergoing outpatient treatment for hepatic cirrhosis due to hepatitis B virus, was diagnosed with hepatocellular carcinoma (HCC) by various imaging techniques. She underwent a partial hepatectomy. Eight months postoperatively, α-fetoprotein was elevated and contrast-enhanced abdominal CT depicted a right chest-wall mass. 18F-fluorodeoxy- glucose positron emission tomography (FDG-PET) and CT images revealed FDG accumulation only in the mass It was diagnosed as solitary chest-wall metastasis from HCC, and surgical resection was performed. Histologically, its diagnosis was poorly differentiated hepatocellular carcinoma the same as that for the primary lesion. In Japaa there are only 9 other reported cases of hematogenous chest-wall metastasis not caused by surgical wound or puncture route of biopsy or treatment. Many cases received surgical treatment, including one case had superior vena cava syndrome, an oncologic emergency. In high-risk patient for HCC or during on postoperative follow-up, it could be necessary to perform tests and treatments considering chest-wall metastasis. © 2010 The Japan Society of Hepatology.