Rare Site Hepatocellular Carcinoma Metastasis

Enrique Boldo,1 Ana Santafe,1 Araceli Mayol,1 Rafael Lozoya,1 Alba Coret,1 Diana Escribano,1 Carlos Fortea-Sanchis,1 Andres Muñoz,1 Juan Carlos Pastor,1 Guillermo Perez de Lucia,1 Nuria Bosch2 1Department of Surgery, Consorcio Hospitalario Provincial de Castellon, Castellon, Spain; 2Patho...

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Main Authors: Boldo E, Santafe A, Mayol A, Lozoya R, Coret A, Escribano D, Fortea-Sanchis C, Muñoz A, Pastor JC, Perez de Lucia G, Bosch N
Format: Article
Language:English
Published: Dove Medical Press 2020-03-01
Series:Journal of Hepatocellular Carcinoma
Subjects:
Online Access:https://www.dovepress.com/rare-site-hepatocellular-carcinoma-metastasis-peer-reviewed-article-JHC
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author Boldo E
Santafe A
Mayol A
Lozoya R
Coret A
Escribano D
Fortea-Sanchis C
Muñoz A
Pastor JC
Perez de Lucia G
Bosch N
author_facet Boldo E
Santafe A
Mayol A
Lozoya R
Coret A
Escribano D
Fortea-Sanchis C
Muñoz A
Pastor JC
Perez de Lucia G
Bosch N
author_sort Boldo E
collection DOAJ
description Enrique Boldo,1 Ana Santafe,1 Araceli Mayol,1 Rafael Lozoya,1 Alba Coret,1 Diana Escribano,1 Carlos Fortea-Sanchis,1 Andres Muñoz,1 Juan Carlos Pastor,1 Guillermo Perez de Lucia,1 Nuria Bosch2 1Department of Surgery, Consorcio Hospitalario Provincial de Castellon, Castellon, Spain; 2Pathology Department, Consorcio Hospitalario Provincial de Castellon, Castellon, SpainCorrespondence: Enrique BoldoServicio de Cirugia, Consorcio Hospitalario Provincial de Castellon, Avenida Dr Clara 19, Castellon 12002 Tel +34-964359700Fax +34-964354301Email eboldo@aecirujanos.esIntroduction: Besides more common sites such as lung or peritoneum, hepatocellular carcinoma (HCC) can metastatize to rare sites. We report herein a new metastatic site of HCC: the nail-bed. We also review other recently reported rare site HCC metastases (RSHM).Case Report: A 66-year-old woman with a 12-year history of resected-stage IA HCC who later presented lung, spleen and brain metastases treated with surgery, systemic therapies (sorafenib, sunitinib, capecitabine) and radiotherapy. The patient was referred to us because of a painful and rapidly evolving mass in the nail-bed of the left thumb. Biopsy confirmed nail-bed HCC metastasis, and the finger was amputated. The patient died few weeks later.Conclusion: This case was an opportunity for us to review RSHM. This type of metastasis seems to be an early event, in the context of advanced stage HCC with elevated protein induced by vitamin K absence-II (PIVKA II). The Lee nomogram is useful in detecting patients at high risk of developing RSHM. We would suggest insisting on systemic treatment in these metastatic patients although overall survival after RSHM diagnosis is poor.Keywords: hepatocellular carcinoma, rare metastasis, surgery, PIVKA II, systemic treatment, nomogram
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spelling doaj.art-421797b801af4bf0869afe7021c0599c2022-12-21T17:59:35ZengDove Medical PressJournal of Hepatocellular Carcinoma2253-59692020-03-01Volume 7394452703Rare Site Hepatocellular Carcinoma MetastasisBoldo ESantafe AMayol ALozoya RCoret AEscribano DFortea-Sanchis CMuñoz APastor JCPerez de Lucia GBosch NEnrique Boldo,1 Ana Santafe,1 Araceli Mayol,1 Rafael Lozoya,1 Alba Coret,1 Diana Escribano,1 Carlos Fortea-Sanchis,1 Andres Muñoz,1 Juan Carlos Pastor,1 Guillermo Perez de Lucia,1 Nuria Bosch2 1Department of Surgery, Consorcio Hospitalario Provincial de Castellon, Castellon, Spain; 2Pathology Department, Consorcio Hospitalario Provincial de Castellon, Castellon, SpainCorrespondence: Enrique BoldoServicio de Cirugia, Consorcio Hospitalario Provincial de Castellon, Avenida Dr Clara 19, Castellon 12002 Tel +34-964359700Fax +34-964354301Email eboldo@aecirujanos.esIntroduction: Besides more common sites such as lung or peritoneum, hepatocellular carcinoma (HCC) can metastatize to rare sites. We report herein a new metastatic site of HCC: the nail-bed. We also review other recently reported rare site HCC metastases (RSHM).Case Report: A 66-year-old woman with a 12-year history of resected-stage IA HCC who later presented lung, spleen and brain metastases treated with surgery, systemic therapies (sorafenib, sunitinib, capecitabine) and radiotherapy. The patient was referred to us because of a painful and rapidly evolving mass in the nail-bed of the left thumb. Biopsy confirmed nail-bed HCC metastasis, and the finger was amputated. The patient died few weeks later.Conclusion: This case was an opportunity for us to review RSHM. This type of metastasis seems to be an early event, in the context of advanced stage HCC with elevated protein induced by vitamin K absence-II (PIVKA II). The Lee nomogram is useful in detecting patients at high risk of developing RSHM. We would suggest insisting on systemic treatment in these metastatic patients although overall survival after RSHM diagnosis is poor.Keywords: hepatocellular carcinoma, rare metastasis, surgery, PIVKA II, systemic treatment, nomogramhttps://www.dovepress.com/rare-site-hepatocellular-carcinoma-metastasis-peer-reviewed-article-JHChepatocellular carcinoma. rare metastasis. surgery. pivka ii. systemic treatment. nomogram.
spellingShingle Boldo E
Santafe A
Mayol A
Lozoya R
Coret A
Escribano D
Fortea-Sanchis C
Muñoz A
Pastor JC
Perez de Lucia G
Bosch N
Rare Site Hepatocellular Carcinoma Metastasis
Journal of Hepatocellular Carcinoma
hepatocellular carcinoma. rare metastasis. surgery. pivka ii. systemic treatment. nomogram.
title Rare Site Hepatocellular Carcinoma Metastasis
title_full Rare Site Hepatocellular Carcinoma Metastasis
title_fullStr Rare Site Hepatocellular Carcinoma Metastasis
title_full_unstemmed Rare Site Hepatocellular Carcinoma Metastasis
title_short Rare Site Hepatocellular Carcinoma Metastasis
title_sort rare site hepatocellular carcinoma metastasis
topic hepatocellular carcinoma. rare metastasis. surgery. pivka ii. systemic treatment. nomogram.
url https://www.dovepress.com/rare-site-hepatocellular-carcinoma-metastasis-peer-reviewed-article-JHC
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