ABSTRACT
The most common site of extrahepatic metastasis in cases of advanced hepatocellular carcinoma is the lung. A 60-year-old Korean male had been previously diagnosed with hepatocellular carcinoma and was treated several times with transcatheter arterial chemoembolization prior to a regime of sorafenib after multiple bone metastases were detected. Despite 2 months of systemic treatment, the disease progressed, and newly developed cavitary nodules and ground glass opacities were observed on a chest computed tomography scan. Initially the patient was diagnosed with septic pneumonia and was subsequently treated with antibiotics over 2 weeks, with no observable improvement. A percutaneous transthoracic needle aspiration biopsy was performed to ascertain the noninfectious origin of the lung lesions. As a result, a rare form of pulmonary metastasis from hepatocellular carcinoma was discovered. Unfortunately, there were no available treatment options for the patient and so end-of-life care was recommended.