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Year : 2016  |  Volume : 1  |  Issue : 4  |  Page : 1-4

Unusual metastasis of hepatocellular carcinoma

Medicine C, Hepatogastroenterology Department, IBN SINA University Hospital Rabat, Morocco

Correspondence Address:
L Talioua
Medicine C, Hepatogastroenterology Department, IBN SINA University Hospital Rabat
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Source of Support: None, Conflict of Interest: None

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Hepatocellular carcinoma is the most common primary tumor of the liver and is estimated to cause more than a quarter of a million deaths each year throughout the world. Extrahepatic metastasis of HCC occurs in about 30-50% of patients, and it depends on HCC stages. Materials and methods: We carried out a retrospective study including 16 patients, 10 men and 6 women with a mean age of 58.5 years ranging from 37 years to 75 years. 13 patients had cirrhosis due to hepatitis C virus, 1 patient had cirrhosis due to viral B infection and 2 patients had HCC within a non-cirrhotic liver. All patients had one or more HCC, ranging in size from 2 to 10 cm. The AFP was normal in 11 cases and elevated in 4 cases (> 200 ng / ml). We collected 4 cases of adrenal metastases, 3 costovertebral metastases, 2 gastric metastases, 2 brain metastases, 1 cranial metastasis, 1 clavicular metastasis, 1 ovarian metastasis, 1 nasopharyngeal metastasis, and a case of metastasis in the path of percutaneous biopsy of HCC. In 4 cases the diagnosis of HCC and metastasis was synchronous while in 12 cases median time from diagnosis of hepatocellular carcinoma and extrahepatic HCC was 15.5 months. Therapeutic abstention was decided in 14 patients for the advanced stage of the disease. Cutaneous metastasis was resected surgically and HCC occurring in healthy liver was treated by lumpectomy and upper pole gastrectomy in gastric metastasis. The average survival was estimated at 14 months with a decline of 17.3 months, 6 cases were lost to follow and 6 deaths occurred in our series. Conclusion: The incidence of unusual and extrahepatic metastasis of HCC diagnosed during clinical course was not frequent. The diagnostic procedures for extrahepatic metastasis have not been standardized, however considering the substantial advances in treatment of HCC, the detection of extrahepatic HCC is crucial for patients to receive appropriate therapy, which ultimately determines patient survival.

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