Long-term survival of patients with hepatocellular carcinoma with hepatic, pulmonary, peritoneal and rare colon metastasis: A case report

Abstract

BACKGROUND

Hepatocellular carcinoma (HCC) is a highly malignant cancer that often metastasizes and has a poor prognosis. Gastrointestinal tract metastases are rare, and colon metastases are even rarer. The long-term survival of patients with multiple intrahepatic and extrahepatic metastases, especially to the colon, has not been previously reported.

CASE SUMMARY

We present an atypical clinical case of a patient with liver, right lung, peritoneal, and colon metastases diagnosed successively following hepatic resection for primary HCC. Comprehensive treatment, including partial liver, lung and colon resection, palliative management such as systemic chemotherapy, trans-arterial chemoembolization, targeted therapy with sorafenib, and cryotherapy were attempted. Despite his early metastases, the patient remained relatively healthy for 8 years after diagnosis.

CONCLUSION

This case indicates that comprehensive treatment is beneficial for certain patients with metastatic HCC. Clinicians should be alert as to the possibility of rare site metastatic tumors that may be easily misdiagnosed as primary tumors.

Keywords: Hepatocellular carcinoma; Multiple metastasis; Rare colon metastasis; Comprehensive treatments; Long-term survival; Case report

Core Tip: Hepatocellular carcinoma (HCC) is a highly malignant cancer worldwide, which often metastasizes, but unusually to the gastrointestinal tract and particularly rare to the colon. We presented an atypical clinical case of a patient with liver, right lung, peritoneal and colon metastases diagnosed successively following hepatic resection for primary HCC. Despite his early metastases, the patient remained relatively healthy for 8 years. This case indicates that comprehensive treatment is beneficial for certain patients with metastatic HCC. Furthermore, clinicians should be alert as to the possibility of rare site metastatic tumors that may be easily misdiagnosed as primary tumors. We believe this article will be very useful to anyone who is interested in this field.