Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 16, 2021; 9(14): 3334-3341
Published online May 16, 2021. doi: 10.12998/wjcc.v9.i14.3334
Skeletal muscle metastases of hepatocellular carcinoma: A case report and literature review
Qi Song, Xiao-Feng Sun, Xiao-Li Wu, Yi Dong, Le Wang
Qi Song, Xiao-Feng Sun, Xiao-Li Wu, Yi Dong, Le Wang, Department of Ultrasound, Bethune First Hospital of Jilin University, Changchun 130000, Jilin Province, China
Author contributions: Song Q was the patient’s physician, conceived the idea of the case report, and wrote the original draft; Dong Y and Wang L provided, analyzed and interpreted the imaging findings and contributed to manuscript drafting; Sun XF and Wu XL reviewed the literature and contributed to manuscript drafting; All authors approved the final version of the manuscript.
Informed consent statement: Informed consent for publication was obtained from the patient.
Conflict-of-interest statement: The authors declare that they have no competing interests.
CARE Checklist (2016) statement: The authors have read the CARE Checklist, and the manuscript was prepared and revised according to the CARE Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xiao-Feng Sun, MD, PhD, Academic Research, Professor, Department of Ultrasound, Bethune first Hospital of Jilin University, No. 71 Xinmin Street, Changchun 130000, Jilin Province, China. cuiyz18@mails.jlu.edu.cn
Received: September 28, 2020
Peer-review started: September 28, 2020
First decision: December 14, 2020
Revised: December 24, 2020
Accepted: January 7, 2021
Article in press: January 7, 2021
Published online: May 16, 2021
Processing time: 212 Days and 20.3 Hours
Abstract
BACKGROUND

The metastasis of liver cancer to skeletal muscle is extremely rare compared to other sites. We herein report a case of rapidly developing skeletal metastases following liver transplantation due to primary liver cancer.

CASE SUMMARY

A 70-year-old male with underlying chronic hepatitis B virus infection was diagnosed with hepatocellular carcinoma (HCC), for which he underwent liver transplantation in 2014. Six years after receiving the transplant, pathological examination confirmed the presence of HCC without vascular invasion. He was admitted to the hospital with a rapidly growing mass on his right thigh. Ultrasound examination revealed a mixed echo mass in the lateral soft tissue of the middle part of the right femur. Magnetic resonance imaging showed heterogeneous iso-signal intensity on T1-weighted images and heterogeneous hyper-intensity on T2-weighted images compared to the surrounding muscles. Pathological examination of the ultrasound-guided needle biopsy specimen revealed that it was similar to the previously detected liver cancer; the diagnosis was metastasis of HCC. Surgical excision was performed. There were no other sites of metastasis, and the patient recovered well after surgery.

CONCLUSION

This report presents a rare case of skeletal metastasis following liver transplantation for HCC. The study suggests a possible role for skeletal muscle metastasis mechanisms, which should be the focus of future research.

Keywords: Hepatocellular carcinoma; Transplant; Skeletal muscle metastasis; Pathological; Case report

Core Tip: Skeletal muscle metastasis from hepatocellular carcinoma is extremely rare and is often accompanied by metastasis to other organs. We herein report a case of rapidly developing skeletal metastases after liver transplantation due to primary liver cancer, without any other organ metastases. There is a dearth of literature on the detailed prognosis of patients with skeletal muscle metastasis. Therefore, the correct interpretation of the molecular and pathophysiological mechanisms of skeletal muscle metastasis may help with the development of novel therapies to combat the progression of the disease.