Can Hepatocellular Carcinoma (HCC) Produce Unconventional Metastases? Four Cases of Extrahepatic HCC

AIMS AND BACKGROUND: Extrahepatic spread of hepatocellular carcinoma (HCC) diagnosed during the clinical course of the disease is not frequent; however, with the prolonged survival of HCC patients, the incidence of extrahepatic metastases seems to be increasing. METHODS AND STUDY DESIGN: We present four unusual cases of extrahepatic metastasis from HCC: the first concerns a patient who underwent a liver transplantation for HCC with cirrhosis and three years later developed metastases in the lung and the left orbit; the second is that of a patient who developed an extraperitoneal pararectal metastasis; in the third case a large osteolytic lesion developed on the left iliac bone, and in the fourth case we found an isolated metastasis in the left mandible. RESULTS AND CONCLUSIONS: These cases offer important information related to the unusual biology of isolated metastases from HCC after successful treatment of the primary cancer.