A rare case of cranial metastasis from an initial presentation of hepatocellular carcinoma

Cranial metastases from hepatocellular carcinoma (HCC) has been seldom reported. Reported herein is the case of a painless parietal bone mass as an initial presentation of HCC in a 63-year-old female patient who was subsequently diagnosed to have HCV related cirrhosis. The biopsy from cranial lesion was confirmatory of HCC on immunohistochemistry. The patient had no known history of chronic liver disease. The presented diagnosis was made through detailed history, laboratory parameters and cross sectional imaging.

An Unusal Presentation of Follicular Carcinoma of Thyroid

Although the incidence of thyroid carcinoma hasincreased in recent years, metastatic spread to the skullis rare. Here we report a case of an occult follicularthyroid carcinoma. A 65 year old female patientpresented with a large swelling of 20 × 20 cm over thefrontal and parietal regions for 2 years. MagneticResoning Imaging (MRI) showed well definedlobulated mass in bilateral frontal and parietal regionswith cystic and solid components. Incisional biopsy ofthe mass was done and was reported as metastaticfollicular carcinoma with transformation to anaplasticvariant. In view of this report the patient underwenttotal thyroidectomy, the biopsy report confirmed thediagnosis of follicular carcinoma. Surgery is the maintreatment for resectable metastatic differentiated131 thyroid carcinoma, followed by I ablation andthyroid stimulating hormone suppression withlevothyroxine

Skull Metastasis of Gastric Gastrointestinal Stromal Tumor Successfully Managed by Surgery

Gastrointestinal stromal tumors (GISTs) are rare, but are the most common mesenchymal neoplasm of the gastrointestinal tract. The most common sites of metastasis are liver and peritoneum, while bone metastasis is rare. We report on a patient with skull metastasis after seven years of treatment with imatinib for metastatic GIST. She underwent metastasectomy consisting of craniectomy with excision of the mass, and cranioplasty and continued treatment with imatinib and sunitinib, without evidence of cranial recurrence. She died of pneumonia sepsis one year after metastasectomy. Skull metastasis of GIST is a very rare presentation, and an aggressive multidisciplinary approach should be considered whenever possible.

Tumor del estroma extragastrointestinal (EGIST) mesentérico: entidad rara con evolución atípica / Mesenteric extragastrointestinal stromal tumor (EGIST): a rare variant with unusual behaviour

Los tumores del estroma gastrointestinal (GIST) constituyen el tipo más frecuente de neoplasia mesenquimal del estroma gastrointestinal. Los casos que presentan características similares clínico-patológicas y moleculares que los GIST se ubican en los tejidos blandos del abdomen, y han sido denominados tumores del estroma extragastrointestinal (EGIST). Son infrecuentes y conocemos poco acerca de su pronóstico y manejo más adecuado. Presentamos el caso de una paciente diagnosticada de EGIST de localización en mesocolon con una evolución atípica. Este tipo de situaciones plantea un reto al diagnóstico diferencial a lo largo de todo el proceso y enfatiza la importancia de un manejo multidisciplinar.

Gastrointestinal stromal tumours (GIST) are the most common mesenchymal tumours of the gastrointestinal tract. Those GIST arising outside the gastrointestinal tract are called extra-gastrointestinal stromal tumours (EGIST) and share clinical, pathological and molecular features. They are very rare and very little is known about the correct management and prognosis of these neoplasms. The case is presented of a patient with a mesenteric EGIST and an unusual outcome. Its differential diagnosis is difficult, and the need for a multidisciplinary team approach is emphasised.

A Case of Metastatic Hepatocellular Harcinoma to the Skull

PURPOSE: Hepatocellular carcinoma is a highly malignant disorder that carries a poor prognosis. It is a fatal disease with a high incidence, especially in areas with an already high prevalence of hepatitis types B & C. The primary sites for extrahepatic metastases include the lung and adrenal glands, while bone, especially the skull, is rarely affected. This paper notes a rare case of extrahepatic metastasis to the skull. METHODS: A 62-year-old male, with a previous history of hepatitis B, developed hepatocellular carcinoma. The patient received several treatments of TACE(Transarterial chemoembolization) and PEI(Percutaneous ethanol injection) with no resolution, which prompted a hepatology follow-up. Recently, patient requested to have an enlarging mass on the forehead removed, for which an incisional biopsy was perfomed since the mass involved bone. Pathologic findings confirmed metastatic HCC. RESULTS: The only complication encountered during the incisional biopsy was profuse bleeding from the incision site. There was some difficulty in controlling the bleeding, but hemostasis was achieved using Gelfoam. There were no postoperative complications. The patient was treated with radiotherapy and follow-up CONCLUSION: Patients with cranial metastasis of HCC presents with a subcutaneous mass and a headache while simple X-rays show osteolytic lesions, computed tomography studies are needed for a definitive diagnosis. Treatement options include radiotherapy, surgery and chemotherapy. In this case the patient received radiotherapy. Skull metastases should be considered in the differential diagnosis of patients who present with a subcutaneous mass and an osteolytic defect on X-ray films of the skull.

Two Cases Of Primary Hepatocellular Carcinoma With Skull Metastasis / 대한내과학회지

Primary hepatocellular carcinoma (HCC) is one of the most common tumors in the world. HCC often metastases to the lung and the regional lymph nodes, but rarely to the bones. The most frequent sites of skeletal metastasis are the rib, spine, femur, pelvis and humerus, but the metastasis to the skull is very rare in HCC. Especially, the metastasis to the skull alone, or skull mass presented as first sign in HCC is extremely rare. We report a 74-year-old female who had HCC with the solitary skull metastasis and a 42-year-old male with HCC presented skull metastasis as the initial clinical manifestation.

Skull Metastases of Hepatocellular Carcinoma and Presurgical Embolization with Flow-Dependent Micro-Platinum Coil: Case Report

Surgical removal of bone metastasis from hepatocellular carcinoma frequently produces profuse bleeding. To reduce bleeding, we have performed preoperative embolization of tumor feeding artery with flow-dependent micro-platinum coils during superselective angiography in a case of frontal bone metastasis from hepatocellular carcinoma. The tumor was removed easily with minimal bleeding after the embolization, so we report the case with review of the relevant literature.

Hepatocellular Carcinoma with Intracranial, Skull and Orbital Metastasis

A case of rare intracranial, skull and orbital metastasis is presented. A 34-year-old man was found to have mental deterioration with proptosis of the right eye and scalp sellings. The intracranial, skull and orbital tumors were verified to be hepatocelluar carcinoma and the patient died 3 days after admission. The literature of hepatoma with cranial and orbital metastasis is briefly reviewed.

Skull Metastasis of Hepatocelluar Carcinoma: A Case Report

Skull metastasis of hepatocelluar carcinoma are rarely reported, even in the Orient and the Africa where this carcinoma is one of the relatively common malignancies. One case with the skull metastasis of the hepatocelluar carcinoma, which no literature was found about the distant metastasis to the skull bone only in Korea, is reported with the histochemical stain and the relevant literatures are reviewed.

Tremendous Skull Metastasis from Follicular Thyroid Carcinoma: Case Reort

A rare and tremendous skull metastasis from the follicular thyroid carcinoma is reported with review of the articles. Follicular carcinoma of the thyroid with distant metastasis is considered a relatively progressive tumor associated with poor five-year survival rate. The insidious character of the primary growth of the thyroid carcinoma is the long latent period which supervenes between the recognition of the primary growth and its secondary metastasis. The clinicopathological features, plain X-ray and C-T findings are discussed.

A Case of Peripheral Neuroblastoma (Involing Skull)

The peripheral neuroblastomas are malignant neoplasms that originate from the adrenal gland and sympathetic nervous tissues. They usually occur in childhood. They exhibit such malignant features that they metastasize early to lung, liver, bone, rarely skull and other structures. The patients with peripheral neuroblastoma have short duration of symptom and short survival period. They reveal the characteristic light microscopic features that resemble other small cell carcinomas. The establishment of final diagnosis of peripheral neuroblastoma needs various special stainings for small cell carcinomas, and the electron microscopic findings are the most reliable. The authors recently experienced a case of peripheral neuroblastoma in a 26-year-old man which involved right frontoparietal skull vault. The only chief complaint was a local non-tender mass at right frontoparietal scalp. Neither headache nor any neurological deficits was detected. Simple skull X-ray revealed a punched out radiolucency at right frontoparietal bone and brain CT showed a superficial elliptical high density mass that enhanced strongly. The mass was totally removed by wide craniectomy. The tumor invaded and penetrated the dura but the arachnoid membrane. At the tumor bed was not invaded by the tumor. The tumor was confirmed as peripheral neuroblastoma by various special stainings for small cell carcinomas. Following surgical resection of the mass, post-operative radiotherapy was offered(4800 rads for about 5 weeks). The patient aggrevated progressively and showed numerous metastases to such bones as lumbar vertebrae, pelvis and humerus to became paraplegic. 8 months after the operation, the patient died.