Case Report
Copyright ©2007 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. May 21, 2007; 13(19): 2758-2760
Published online May 21, 2007. doi: 10.3748/wjg.v13.i19.2758
A patient with spinal metastasis from hepatocellular carcinoma discovered from neurological findings
Katsuyoshi Tamaki, Ichiro Shimizu, Mari Urata, Nao Kohno, Hiroshi Fukuno, Susumu Ito, Nobuya Sano
Katsuyoshi Tamaki, Ichiro Shimizu, Mari Urata, Nao Kohno, Hiroshi Fukuno, Susumu Ito, Department of Digestive and Cardiovascular Medicine, Institute of Health Biosciences, The University of Tokushima Graduate School, Japan
Nobuya Sano, Division of Pathology, Tokushima University Hospital, Tokushima, Japan
Author contributions: All authors contributed equally to the work.
Correspondence to: Katsuyoshi Tamaki, Department of Digestive and Cardiovascular Medicine, Tokushima University School of Medicine, Kuramoto-cho, Tokushima 770-8503, Japan. tamaki@clin.med.tokushima-u.ac.jp
Telephone: +81-88-6337124 Fax: +81-88-6339235
Received: January 5, 2007
Revised: February 6, 2007
Accepted: March 1, 2007
Published online: May 21, 2007
Abstract

Although spinal tumors are uncommon, they may reduce survival or cause serious functional disorders in the extremities. Metastatic spinal tumors from malignant tumors can induce symptoms of spinal cord compression, such as paraplegia, quadriplegia, and vesicorectal disturbance, which are aggravated with progression of the diseases and time. We report a patient with hepatocellular carcinoma (HCC) who was suspected of having spinal lesions based on neurological findings, and a metastatic spinal tumor was found by imaging examination. Assuming that metastasis had occurred at the time lumbar pain developed, the patient reached the level of gait disturbance within only 4 mo, showing a rapid advancement of symptoms. If early diagnosis had been possible, treatment could be performed before acute myelopathy progressed to complete paralysis. We speculate that the terminal stage of HCC is not only liver failure associated with intrahepatic lesions but also metastasis to other regions, treatment for individual pathologies therefore, will be needed, which constitutes an important issue.

Keywords: Hepatocellular carcinoma; Spinal cord metastasis; Brain metastasis