The chest wall tumor a rare clinical presentation of hepatocellular carcinoma metastasis

Štefan Pörsök


Backrounds: Extrahepatic metastatic spread of hepatocellular carcinoma (HCC) is present at the time of diagnosis in 5-15% of HCC patients. The most common site of  metastastic spread is lung, bone, lymph node. The isolated chest wall localization is extremly rare. Case: We report on a 58-years old patient with large, synchronous chest wall HCC metastasis with solitary primary HCC. He underwent a radical, surgical en-block metastasectomy and subsequent anatomic liver resection. Removal of this metastasis further lead to agressive dissemination to different sites during the course of the disease and subsequently the patient was treated with antiangiogenic therapy and after failure with systemic chemotherapy.  Combined multimodality treatment in this case lead to 22-moths overall survival. We suggest, that initial huge presentation of chest wall mestastasis and consecutive agressive dissemination after surgical removal, could be explain by biological process named ’tumor self-seeding’ by circulating tumor cells (CTC). Conclusion: The chest wall HCC metastasis is rare entity associated with poor prognosis. Radical surgical approach is limited to a minority of patients and may be justified for the treatment of extrahepatic metastases on case by case bases.

Key words - hepatocellular carcinoma - chest wall metastasis – metastasectomy - tumor self-seeding 

Klíčová slova

Key words - hepatocellular carcinoma - chest wall metastasis – metastasectomy - tumor self-seeding

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