Solitary skull metastasis as initial manifestation of hepatocellular carcinoma

World J Surg Oncol. 2008 Jun 21;6:66. doi: 10.1186/1477-7819-6-66.


Background: A solitary skull metastasis from hepatocellular carcinoma (HCC) prior to diagnosis of the primary tumor without liver dysfunction is a very rare event.

Case presentation: A 71-year-old male, without known liver disease, presented to our institution with a palpable occipital scalp mass. On brain magnetic resonance imaging (MRI), a highly enhanced and osteolytic skull tumor was observed. The histological diagnosis obtained from the percutaneous needle biopsy was a cranial metastasis from HCC. The metastatic tumor was removed via occipital craniectomy, and the two primary liver mass lesions were subsequently treated by transarterial chemoembolization.

Conclusion: An isolated skull metastasis may be the sole initial presentation of HCC. Early diagnosis is essential in order to treat the primary disease. A skull metastasis from HCC should be considered in the differential diagnosis in patients with subcutaneous scalp mass and osteolytic defects on X-ray.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Biopsy, Needle
  • Carcinoma, Hepatocellular / pathology*
  • Carcinoma, Hepatocellular / therapy
  • Chemoembolization, Therapeutic
  • Humans
  • Liver Neoplasms / pathology*
  • Liver Neoplasms / therapy
  • Magnetic Resonance Imaging
  • Male
  • Skull / pathology*
  • Skull Neoplasms / diagnosis*
  • Skull Neoplasms / secondary*
  • Skull Neoplasms / surgery
  • Treatment Outcome