A pathological fracture and a solitary mass in the right clavicle: an unusual first presentation of HCC and the role of immunohistochemistry.

Journal Article (Journal Article)

Hepatocellular carcinoma (HCC) is an aggressive malignant tumor that occurs throughout the world. Μetastases from hepatocellular carcinoma (HCC) were generally considered to be rare in the past, because the carcinoma had an aggressive clinical course. In our era, has been reported that extra-hepatic metastases occur in 13.5%-41.7% of HCC patients and this is considered as terminal-stage cancer. The prognosis for patients at this stage continues to be poor due to limited effective treatment. The common sites of extrahepatic metastases in patients with HCC are the lungs, regional lymph nodes, kidney, bone marrow and adrenals. We present here an extremely infrequent case of a patient, without known liver disease, in which the presenting symptom was a pathological-in retrospect-fracture of his right clavicle which wasn't properly evaluated, until he presented a bulky mass in the region 6 months later. For our patient, the added diagnostic difficulty alongside the unknown liver disease, has been that the clavicular metastases was the first presentation of any metastatic disease, rather than the more common sites of HCC spread to adjacent lung or lymph nodes.

Full Text

Duke Authors

Cited Authors

  • Mantonakis, EI; Margariti, TS; Petrou, AS; Stofas, AC; Lazaris, AC; Papalampros, AE; Moris, DN; Michail, PO

Published Date

  • March 2012

Published In

Volume / Issue

  • 10 /

Start / End Page

  • 50 -

PubMed ID

  • 22400493

Pubmed Central ID

  • PMC3310740

Electronic International Standard Serial Number (EISSN)

  • 1477-7819

International Standard Serial Number (ISSN)

  • 1477-7819

Digital Object Identifier (DOI)

  • 10.1186/1477-7819-10-50


  • eng