Bone Metastasis as the First Presentation of Hepatocellular Carcinoma
KW Leung, JLY Leung, ANL Sy, CS Cheng, KF Chan
Hong Kong J Radiol 2010;12:113-6
This report is of a patient with multifocal bilobar hepatocellular carcinoma who presented with bone pain related to bone metastasis. Radiograph of the pelvis showed an expansile osteolytic bone lesion in the right superior pubic ramus. Review of the literature showed that the radiographic appearance was typical of bone metastasis from hepatocellular carcinoma, as well as renal cell carcinoma and thyroid carcinoma. This entity is not usually included in the differential diagnosis of expansile lytic bone lesion, possibly due to the rarity of hepatocellular carcinoma in western countries. If a patient presents with an expansile osteolytic bone lesion, bone metastasis from hepatocellular carcinoma should be considered in addition to renal cell carcinoma and thyroid carcinoma, especially in areas such as Hong Kong where the incidence of hepatocellular carcinoma is high.
中文摘要
骨轉移作為原發性肝癌首發表徵個案報道
梁錦榮、梁禮賢、施雅倫、鄭志成、陳鉅發
這份病例報告是關於一個肝臟兩葉有多處原發性肝癌的病人以骨痛骨轉移作為首發表徵的描述。骨 盆X光片顯示右側恥骨上支有膨脹溶骨性病變。經翻查文獻，發現該X光片的外觀是典型的原發性肝 癌、腎細胞癌或甲狀腺癌的骨轉移。可能是由於原發性肝癌在西方國家比較罕見，原發性肝癌骨轉 移通常不包括在鑑別診斷膨脹性溶骨骨病變之內。如果在原發性肝癌發病率很高的地方，例如在香 港，遇到一例膨脹溶骨性病變的病人，除了要考慮腎細胞癌和甲狀腺癌的骨轉移之外，還要考慮原 發性肝癌的骨轉移。