Case Report
Copyright ©2006 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Apr 7, 2006; 12(13): 2139-2142
Published online Apr 7, 2006. doi: 10.3748/wjg.v12.i13.2139
Chest wall metastasis from unknown primary site of hepatocellular carcinoma
Yil Sik Hyun, Ho Soon Choi, Joong Ho Bae, Dae Won Jun, Hang Lak Lee, Oh Young Lee, Byung Chul Yoon, Min Ho Lee, Dong Hoo Lee, Choon Shuk Kee, Jung Ho Kang, Moon Hyang Park
Yil Sik Hyun, Ho Soon Choi, Joong Ho Bae, Dae Won Jun, Hang Lak Lee, Oh Young Lee, Byung Chul Yoon, Min Ho Lee, Dong Hoo Lee, Choon Shuk Kee, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
Jung Ho Kang, Department of Thoracic Surgery, Hanyang University College of Medicine, Seoul, Korea
Moon Hyang Park, Department of Pathology, Hanyang University College of Medicine, Seoul, Korea
Author contributions: All authors contributed equally to the work.
Correspondence to: Ho Soon Choi, MD, Department of Gastroenterology, Hanyang Medical Center, 17, Haengdang-dong, Seongdong-gu, Seoul 133-792, Korea. choihs@hanyang.ac.kr
Telephone: +82-2-2290-8379 Fax: +82-2-2290-8344
Received: June 29, 2005
Revised: July 11, 2005
Accepted: July 20, 2005
Published online: April 7, 2006
Abstract

Previous reports of a solitary metastatic hepatocellular carcinoma have been rare. Because this tumor has a different treatment modality and prognosis, an accurate differential diagnosis is essential. Here we report a rare case of a solitary chest wall metastasis from unknown primary site of hepatocellular carcinoma. It involves a 51-year-old man who was admitted to our hospital because of a palpable left upper chest wall mass. The mass was resected and pathologic examination confirmed a diagnosis of metastatic hepatocellular carcinoma. Despite our investigation, no evidence was found that indicated the primary origin of the hepatocellular carcinoma. Four months later, the patient was admitted again because of spinal cord compression at the third and fourth thoracic vertebrae. Emergent decompressive laminectomy was performed and microscopic features revealed the same pathology as the initial chest wall mass resected 4 months earlier. After one year, a follow-up abdominal computed tomography (CT) still revealed no evidence of primary hepatocellular carcinoma.

Keywords: Chest wall; Hepatocellular carcinoma; Metastasis