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Taha MM, Taha MM, Ezzat M, Abouhashem S. Evolving metastasis in patients with chronic viral hepatitis as a cause of sciatic pain; pitfalls in diagnosis and management. INTERDISCIPLINARY NEUROSURGERY 2021. [DOI: 10.1016/j.inat.2021.101314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Sarma M, Padma S, Pavithran P, Somasundaram VH, Sundaram PS. Extrahepatic metastases of hepatocellular carcinoma on 18F FDG PET CT. J Egypt Natl Canc Inst 2021; 33:36. [PMID: 34825288 DOI: 10.1186/s43046-021-00086-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 08/19/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND To determine locations, relative frequencies, imaging features, and pattern of distribution of extrahepatic metastasis from hepatocellular carcinoma (HCC) on 2-deoxy-2-[fluorine-18]fluoro-D-glucose (18F-FDG) PET CT. METHODS FDG PET CT scans of 224 consecutive patients of HCC acquired between 2010 and 2018 were reviewed. Fifty-six patients detected with extrahepatic metastasis on FDG PET CT were retrospectively analyzed. Findings were correlated with prior/follow-up imaging studies, clinical findings, FNAC, or biopsy findings whenever available. Descriptive analysis of location, relative frequencies, imaging features, and pattern of distribution of extrahepatic metastasis was done. RESULTS Commonest were metastatic pulmonary nodules (55.3% patients), most of them being well-defined solid lesions (53.5%) with bilateral involvement in 44.6% patients and lower lobes of lungs along with other lobes being more frequently involved (41.0% patients). While in 7.14% patients lung nodules were FDG avid, 23.2% patients had both FDG avid and non-avid pulmonary nodules. Second most common were regional metastatic lymph nodes in 44.65% of patients seen at aortocaval (25%), paraaortic (23.21%), portocaval (21.4%), and left gastric nodal (17.8% of patients) stations. Twenty-five percent of patients had FDG avid lymph nodes and 5.36% patients had both FDG avid and FDG non-avid lymph nodes. Distant metastatic lymph nodes were third most common in 39.2% of patients seen at paratracheal (2.5%), juxtaphrenic (8.9%), and mesenteric lymphnodal (7.1%) stations. Twenty-five percent of patients had FDG avid lymph nodes while 5.36% patients had both FDG avid and FDG non-avid lymph nodes. Skeletal involvement was seen in 32.1% of patients. Commonest sites are vertebrae (16.7%), pelvis (14.2%), and ribs (10.7% patients). Six out of 7 patients had unilateral adrenal gland involvement. Bilateral adrenal gland involvement was seen in 1 patient. FDG non-avid peritoneal/omental metastases was seen in 2 patients. Brain, spleen, and muscle metastatic lesions were seen in 1 patient each out of 56 patients (1.79%). CONCLUSIONS Lungs, regional and distant lymph nodes and skeleton are the most frequently involved sites of extrahepatic metastatic hepatocellular carcinoma. Adrenal glands, muscles, brain and peritoneum are also involved but to a lesser extent.
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Affiliation(s)
- Manjit Sarma
- Department of Nuclear Medicine & Molecular Imaging, Amrita Institute of Medical Sciences, (Amrita Vishwa Vidyapeetham), Cochin, Kerala, 682041, India.
| | - Subramanyam Padma
- Department of Nuclear Medicine & Molecular Imaging, Amrita Institute of Medical Sciences, (Amrita Vishwa Vidyapeetham), Cochin, Kerala, 682041, India
| | - Parvathy Pavithran
- Department of Nuclear Medicine & Molecular Imaging, Amrita Institute of Medical Sciences, (Amrita Vishwa Vidyapeetham), Cochin, Kerala, 682041, India
| | - Vijay Harish Somasundaram
- Department of Nuclear Medicine & Molecular Imaging, Amrita Institute of Medical Sciences, (Amrita Vishwa Vidyapeetham), Cochin, Kerala, 682041, India
| | - Palanisamy Shanmuga Sundaram
- Department of Nuclear Medicine & Molecular Imaging, Amrita Institute of Medical Sciences, (Amrita Vishwa Vidyapeetham), Cochin, Kerala, 682041, India
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Bone Metastases of Hepatocellular Carcinoma: Appearance on MRI Using a Standard Abdominal Protocol. AJR Am J Roentgenol 2016; 206:1003-12. [PMID: 26999036 DOI: 10.2214/ajr.15.15502] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The purpose of this study is to describe the MRI features of hepatocellular carcinoma (HCC) bone metastases. MATERIALS AND METHODS Thirty-three consecutive patients were included. Two radiologists performed qualitative and quantitative analysis. The coordinator searched for clinical and epidemiologic features related to patients and their primary liver tumors. Earlier MRI studies were also reviewed to determine whether bone metastases were already present and prospectively identified. Descriptive statistics and the Lin concordance correlation coefficient were used. RESULTS Chronic hepatitis C virus infection was the most common cause of liver disease (20/32; 62.5%), and diffuse and multifocal HCC were the most frequent types of liver HCCs (28/33; 84.8%). Most lesions were located at the spine (109/155; 70.3%), with high signal intensity on fat-suppressed T1-weighted (54/62; 87.1%) and T2-weighted (53/62; 85.5%) images. Bone metastases were predominantly nodular (48/62; 77.4%), confined to the vertebral body (40/60; 66.7%), and best visualized at the arterial phase (40/62; 64.5%). The ring pattern of enhancement was present in 23 of 62 lesions, and the remaining lesions showed diffuse enhancement. Thirty-five of 62 (56.4%) bone metastases showed arterial peak of enhancement. In 13 of 33 (39.9%) patients, bone metastases were not prospectively reported. CONCLUSION Most patients with bone metastases had chronic hepatitis C virus infection and diffuse or multifocal HCC. Metastases are most commonly appreciated as hypervascular focal moderately intensely enhancing nodular masses on the hepatic arterial dominant phase images, with concomitant moderately high signal intensity on fat-suppressed T1- and T2-weighted images.
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Elian MMM, Gawad EAA. The many, atypical presentations of musculoskeletal hepatocellular carcinoma (HCC) metastases. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2014. [DOI: 10.1016/j.ejrnm.2014.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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5
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Becker AK, Tso DK, Harris AC, Malfair D, Chang SD. Extrahepatic metastases of hepatocellular carcinoma: A spectrum of imaging findings. Can Assoc Radiol J 2013; 65:60-6. [PMID: 24239313 DOI: 10.1016/j.carj.2013.05.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2013] [Revised: 04/26/2013] [Accepted: 05/09/2013] [Indexed: 12/18/2022] Open
Abstract
Hepatocellular carcinoma (HCC) is the most common primary tumour of the liver, responsible for significant morbidity and mortality worldwide. In the Western world, it primarily affects patients with cirrhosis, secondary to hepatitis C virus and alcoholism. In the rest of the world, HCC is closely associated with hepatitis B virus infections. Radiologists play a key role in accurately staging HCC, which has important implications for treatment planning. This pictorial review aims to describe the routes of HCC spread and the most frequent sites of metastases, to recognize extrahepatic HCC findings on computed tomography and magnetic resonance imaging, and to understand the implications of HCC staging on treatment planning.
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Affiliation(s)
- Annalisa K Becker
- Department of Radiology, Vancouver General Hospital, University of British Columbia, Vancouver British Columbia, Canada.
| | - David K Tso
- Department of Radiology, Vancouver General Hospital, University of British Columbia, Vancouver British Columbia, Canada
| | - Alison C Harris
- Department of Radiology, Vancouver General Hospital, University of British Columbia, Vancouver British Columbia, Canada
| | - David Malfair
- Department of Radiology, Vancouver General Hospital, University of British Columbia, Vancouver British Columbia, Canada
| | - Silvia D Chang
- Department of Radiology, Vancouver General Hospital, University of British Columbia, Vancouver British Columbia, Canada
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Radiographic characteristics of bone metastases from hepatocellular carcinoma. Contemp Oncol (Pozn) 2012; 16:424-31. [PMID: 23788922 PMCID: PMC3687457 DOI: 10.5114/wo.2012.31773] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2012] [Revised: 05/15/2012] [Accepted: 05/29/2012] [Indexed: 12/21/2022] Open
Abstract
AIM OF THE STUDY Different carcinomas have different characteristics, which may play a crucial role in diagnosis and treatment. Our study was aimed at understanding the development pattern of bone metastasis from hepatocellular carcinoma, based on its imaging characteristics, so as to provide a more targeted treatment. MATERIAL AND METHODS Forty two patients (123 lesions) with hepatocellular carcinoma hospitalized from June 2006 to June 2011 underwent radiotherapy for bone metastasis in our department. Clinical and imaging data were analyzed retrospectively (based on CT imaging, also with reference to MRI, ECT, or PET-CT, etc.). RESULTS One hundred of 123 lesions were vertebral metastases; 23 were non-vertebral. The major form of bone destruction was osteolytic change. Metastasis in the vertebral body was found in 87.8%, and lesions were well distributed in various sections. Vertebral appendix metastasis accounted for 52%, where lesions could be independent of vertebral body metastasis. Formation of a soft tissue mass in bone metastasis was found in 68.6% of all patients. The center of the mass from a vertebral body metastasis was mostly located at the site of the lesion; masses from the vertebral appendix and the pelvis, on the other hand, often presented as a "peripheral mass". Masses were not formed in lesions with pure osteoblastic changes. CONCLUSIONS The most common radiographic feature is an osteolytic lesion, either replaced by soft tissue mass, or invaded by soft tissue mass from the vicinity, which often cause compression syndrome. Vertebral appendix metastasis can exist independently from vertebral body metastasis, which should be paid more attention to avoid missed diagnosis.
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Chen CY, Wu K, Lin WH, Lan TY, Wang SY, Sun JS, Weng PW, Yen RF, Yang RS. High false negative rate of Tc-99m MDP whole-body bone scintigraphy in detecting skeletal metastases for patients with hepatoma. J Formos Med Assoc 2012; 111:140-6. [DOI: 10.1016/j.jfma.2011.01.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2010] [Revised: 11/15/2010] [Accepted: 01/03/2011] [Indexed: 01/12/2023] Open
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8
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Magnetic resonance imaging features of metastatic hepatocellular carcinoma in pelvic bone: two case reports. CURRENT ORTHOPAEDIC PRACTICE 2010. [DOI: 10.1097/bco.0b013e3181e1082b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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9
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Chen CY, Hsueh YT, Lan TY, Lin WH, Wu K, Yang RS. Pelvic skeletal metastasis of hepatocellular carcinoma with sarcomatous change: a case report. Diagn Pathol 2010; 5:33. [PMID: 20500842 PMCID: PMC2889863 DOI: 10.1186/1746-1596-5-33] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2010] [Accepted: 05/25/2010] [Indexed: 11/10/2022] Open
Abstract
Sarcomatoid hepatocellular carcinoma (HCC) is a very rare histologic variant of HCC. The characteristic of skeletal metastatic sarcomatoid hepatocellular carcinoma has never been reported. We reported a patient with sarcomatoid hepatocellular carcinoma pelvic metastasis who presented with huge pelvic metastasis that had relatively small osteolytic lesion centrally located accompanied by huge bipeduncular invasive expansile lesions into surrounding soft tissue. The lesion showed almost non-isotope uptake in 99mTc-methylene diphosphonate bone scintigraphy study. He underwent radiotherapy and tumor excision but the tumor rapidly recurred. In addition, serum α-fetoprotein level was never elevated beyond normal limit (< 20 ng/mL) through the whole course of treatment. We considered sarcomatoid hepatocellular carcinoma bone metastasis a highly aggressive lesion with unusual metastatic pattern. Surgical treatment with adequate safe margin in such a huge tumor with hypervascularity and extensive invasion in the pelvis was difficult; and radiotherapy maybe refractory regarding the sarcomatous nature. Therefore, debulking operation with local symptoms control may provide a better quality of life. And the clinical course suggests sarcomatoid hepatocellular carcinoma is derived from the transition of an ordinary hepatocellular carcinoma.
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Affiliation(s)
- Chih-Yu Chen
- Department of Orthopedic Surgery, National Taiwan University & Hospital, Taipei, Taiwan
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Kim S, Chun M, Wang H, Cho S, Oh YT, Kang SH, Yang J. Bone metastasis from primary hepatocellular carcinoma: characteristics of soft tissue formation. Cancer Res Treat 2007; 39:104-8. [PMID: 19746218 DOI: 10.4143/crt.2007.39.3.104] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2007] [Accepted: 09/22/2007] [Indexed: 01/12/2023] Open
Abstract
PURPOSE To assess the characteristics of bone metastasis from hepatocellular carcinoma and the radiation field arrangement based on imaging studies. MATERIALS AND METHODS Fifty-three patients (84 lesions) with bone metastasis from a primary hepatocellular carcinoma completed palliative radiation therapy. All patients underwent one of following imaging studies prior to the initiation of radiation therapy: a bone scan, computed tomography or magnetic resonance imaging. The median radiation dose was 30 Gy (7 approximately 40 Gy). We evaluated retrospectively the presence of soft tissue formation and the adjustment of the radiation field based on the imaging studies. RESULTS Soft tissue formation at the site of bony disease was identified from either a CT/MRI scan (41 lesions) or from a symptomatic palpable mass (5 lesions). The adjustment of the radiation field size based on a bone scan was necessary for 31 of 41 soft tissue forming lesions (75.6%), after a review of the CT/MRI scan. The median survival from the initial indication of a hepatoma diagnosis was 8 months (2 to 71 months), with a 2-year survival rate of 38.6%. The median survival from the detection of a bone metastasis was 5 months (1 to 38 months) and the 1-year overall survival rate was 8.7%. CONCLUSION It was again identified that bone metastasis from a primary hepatocellular carcinoma is accompanied by soft tissue formation. From this finding, an adjustment of the radiation field size based on imaging studies is required. It is advisable to obtain a CT or MRI scan of suspected bone metastasis for better tumor volume coverage prior to the initiation of radiation therapy.
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Affiliation(s)
- Sangwon Kim
- Department of Radiation Oncology, Ajou University School of Medicine, Suwon, Korea
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Torres M, Alvarez R, López D, Titó L. Hepatocellular carcinoma skull metastasis with both extradural and subcutaneous extension. J Hepatol 2002; 36:569. [PMID: 11943432 DOI: 10.1016/s0168-8278(02)00033-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Affiliation(s)
- Miquel Torres
- Department of Internal Medicine, Holy Spirit Hospital, University of Barcelona, Santa Coloma de Gramenet, Barcelona, Spain
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12
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Tae Lim S, Sohn MH, Kwak JY, Yim CY. Bone imaging of sternal metastasis from hepatocellular carcinoma with disease progression. Clin Nucl Med 2002; 27:311-2. [PMID: 11914683 DOI: 10.1097/00003072-200204000-00023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Seok Tae Lim
- Department of Nuclear Medicine, Institute for Medical Sciences, Chonbuk National University Medical School, 634-18 Keumam-dong, Duckjin-gu, Chonju, Chonbuk 561-712, Korea
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Fukutomi M, Yokota M, Chuman H, Harada H, Zaitsu Y, Funakoshi A, Wakasugi H, Iguchi H. Increased incidence of bone metastases in hepatocellular carcinoma. Eur J Gastroenterol Hepatol 2001; 13:1083-8. [PMID: 11564960 DOI: 10.1097/00042737-200109000-00015] [Citation(s) in RCA: 151] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVES Recently, we often encounter hepatocellular carcinoma patients with bone metastases. We therefore examined the changes in the incidence of bone metastases in hepatocellular carcinoma from 1978 to 1997 and tried to identify the characteristic clinical features. We also discuss the reasons for the increased incidence of bone metastasis in hepatocellular carcinoma. METHODS A total of 673 patients with hepatocellular carcinoma during the period 1978-1997 were studied. Bone metastasis was screened by bone scintigraphy, and bone lesions were confirmed by plain radiography, computed tomography and/or magnetic resonance imaging. The serum levels of the C-terminal telopeptide of type 1 collagen, which represent osteoclastic bone resorption, were also measured. RESULTS The incidence of bone metastasis during the decade 1988-1997 was significantly higher than that during the period 1978-1987. The median survival time of patients with hepatocellular carcinoma during 1988-1997 was also significantly longer than that during 1978-1987. Portal thrombus was found in about half of the patients with bone metastases. The most common site of bone metastases was the vertebra followed by the pelvis, rib and skull in that order. All bone lesions depicted by plain radiograph, computed tomography and/or magnetic resonance imaging were of the osteolytic type, and the serum levels of C-terminal telopeptide of type 1 collagen were significantly elevated in the patients with bone metastases. CONCLUSIONS The increased incidence of bone metastasis in hepatocellular carcinoma in the decade 1988-1997 is first attributed to the prolonged survival rate of hepatocellular carcinoma patients due to recent progress in both the diagnosis and treatment of the disease. Dissemination of hepatocellular carcinoma cells to the vertebra through the portal vein-vertebral vein plexuses due to the presence of portal thrombus and/or portal hypertension may be related to a higher incidence of bone metastasis in hepatocellular carcinoma. Both an early diagnosis and timely treatment of bone metastases are thus called for in the follow-up of hepatocellular carcinoma patients.
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Affiliation(s)
- M Fukutomi
- Division of Gastroenterology, National Kyushu Cancer Centre, Notame 3-1-1, Minami-ku, Fukuoka 811-1395, Japan
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Lee KS, Lee SH, Kang KH, Oh KJ. Metastatic Hepatocellular Carcinoma of the Distal Phalanx of the Thumb. HAND SURGERY : AN INTERNATIONAL JOURNAL DEVOTED TO HAND AND UPPER LIMB SURGERY AND RELATED RESEARCH : JOURNAL OF THE ASIA-PACIFIC FEDERATION OF SOCIETIES FOR SURGERY OF THE HAND 1999; 4:95-100. [PMID: 11089164 DOI: 10.1142/s0218810499000071] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/1999] [Accepted: 03/29/1999] [Indexed: 11/18/2022]
Abstract
A case of metastatic hepatocellular carcinoma of the distal phalanx of the thumb is presented. This case illustrated a rare example of acrometastasis of hepatocellular carcinoma.
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Affiliation(s)
- KS Lee
- Department of Orthopaedic Surgery, Anam Hospital, Korea University, Seoul, Korea
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15
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Matsuura M, Nakajima N, Ito K. Radiation therapy for bone metastasis of hepatocellular carcinoma. Int J Clin Oncol 1998. [DOI: 10.1007/bf02490099] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Otsuka N, Fukunaga M, Morita K, Ono S, Nagai K, Tomomitsu T, Yanagimoto S, Mimura H, Yamamoto S, Hirano Y. Accumulation of 99mTc-HM-PAO in photon deficient areas in bone scan of bone metastasis from hepatocellular carcinoma. Ann Nucl Med 1992; 6:215-20. [PMID: 1336963 DOI: 10.1007/bf03164657] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
To evaluate bone metastasis from hepatocellular carcinoma (HCC), both bone and 99mTc-HM-PAO scintigraphies were performed in six patients with clinically and pathologically confirmed HCC. Two patients had a bone scintigram which revealed abnormal accumulation in the skull base, pelvic bone and thoracic spine. The 99mTc-HM-PAO scans of both these patients also showed abnormal accumulation in the same sites. The bone scintigrams in one patient revealed not only abnormal accumulation in the ribs but also photon deficient areas in the sternum, thoracic spine and femur, while 99mTc-HM-PAO scans showed abnormal accumulation in all these sites. In three patients, bone scintigraphy revealed photon deficient areas in the ribs, pelvic bone and femur, and their 99mTc-HM-PAO scintigrams showed abnormal accumulation in the same sites. Thus, it was shown that, in the detection of bone metastasis from HCC by means of bone scintigraphy, it was necessary to pay attention to hot and cold lesions, and that a combination study with 99mTc-phosphorous compounds and 99mTc-HM-PAO was useful in evaluating these lesions.
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Affiliation(s)
- N Otsuka
- Department of Nuclear Medicine, Kawasaki Medical School, Okayama, Japan
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Abstract
We describe a case of cranial metastasis from an hepatocellular carcinoma studied by computed tomography and cerebral angiography. Although two similar cases have been reported, ours is the first that shows the angiographic findings so clearly and to present with neurological symptoms before primary disease was evident.
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Affiliation(s)
- T Miura
- Department of Radiology, Osaka University Hospital, Japan
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18
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Abstract
Hepatocellular carcinoma may present in various ways, but only a few instances present with symptoms of distant metastases. This report describes a case of hepatocellular carcinoma presenting with acute haemothorax and haemorrhagic shock secondary to spontaneous rupture of chest wall metastasis. Hepatocellular carcinoma is a frequent malignancy in Asia and should be considered in the list of differential diagnosis of spontaneous haemothorax.
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Affiliation(s)
- H H Lin
- Liver Unit, Chang Gung Memorial Hospital, Taipei, Taiwan, ROC
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19
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Abstract
In a consecutive series of 395 patients with pathologically verified hepatocellular carcinoma, 20 patients (5%) had bone metastasis at initial presentation. Of these, 16 were men and four women ranging from 26 to 64 years of age (median, 50 years). The age, sex, hepatitis B surface antigen seropositivity, alpha-fetoprotein level, and frequency of associated cirrhosis were not statistically different from those in patients without initial bone metastasis. Initial presentation was usually the result of spinal lesion with neurologic compression, and chest wall or scalp mass. Metastasis most commonly involved spine and ribs, and occurred as osteolytic lesions or extrapleural mass. Computed tomography proved best for demonstrating an expansile soft tissue mass with bony destruction. Angiography showed hypervascular appearance over the destructive bone area. Treatment results were poor. The follow-up period ranged from 3 weeks to 14 months with a median survival of 5 months. The data suggested that hepatocellular carcinoma be ruled out in patients with osteolytic lesions.
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Affiliation(s)
- C C Liaw
- Department of Internal Medicine, Chang Gung Memorial Hospital, Taipei, Taiwan, Republic of China
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Nagata Y, Nakano Y, Abe M, Takahashi M, Kohno S. Osseous metastases from hepatocellular carcinoma: embolization for pain control. Cardiovasc Intervent Radiol 1989; 12:149-53. [PMID: 2477152 DOI: 10.1007/bf02577380] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Transcatheter arterial embolization for osseous metastasis of hepatocellular carcinoma (HCC) was performed in 7 patients. The embolization therapy was used in patients in whom the feeding artery could be catheterized. All tumors were accompanied by abundant neovascularity and tumor stain. Embolization was successfully performed in 5 patients, all of whom became symptom free within a week. The only complication was local pain which was controlled by nonnarcotic pain medication. Embolization may be a useful treatment method for osseous metastasis of HCC.
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Affiliation(s)
- Y Nagata
- Department of Radiology, Faculty of Medicine, Kyoto University, Japan
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O'Donnell C, Savage A. Radiological appearances of skeletal metastasis from hepatocellular carcinoma. AUSTRALASIAN RADIOLOGY 1988; 32:437-9. [PMID: 2854725 DOI: 10.1111/j.1440-1673.1988.tb02773.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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Abstract
The autopsy of hepatocellular carcinoma at Hines VA Hospital was reviewed for a 33-year period, between 1954 and 1986. The neoplasm is uncommon and bone involvement was observed in 7.3% or in ten of 137 cases. A clinical presentation of osseous metastasis in hepatocellular carcinoma is rare. A brief literature review is also included.
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Affiliation(s)
- P Gattuso
- Laboratory Services, Hines Veterans Administration Hospital, Illinois 60141
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Skeletal Metastases. Radiol Clin North Am 1987. [DOI: 10.1016/s0033-8389(22)02292-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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