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HCC bony metastases are characteristically osteolytic should be included in the list of differential diagnosis of
and hypervascular and thus may rupture spontaneously, progressively growing bony lesions at unusual sites, even
causing hemorrhage. Chen et al. reported a case of a life- in the absence of signs of liver disease.
[7]
threatening hemorrhage from sternal metastasis from HCC.
Similarly, Huang et al. have reported a case of intractable Financial support and sponsorship
[8]
bleeding from an isolated mandibular metastasis, which Nil.
was controlled by palliative radiotherapy.
Conflicts of interest
Very rarely, bony metastases from an unknown primary There are no conflicts of interest.
HCC have been reported. The exact mechanism is not
known, but various theories have been postulated such REFERENCES
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Sorafenib is one of the first-line drugs used in the treatment RW, Imagawa DK. Prevalence of metastases in hepatocellular carcinoma:
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of advanced metastatic HCC. Sorafenib is a tyrosine 6. Kim SU, Kim DY, Park JY, Ahn SH, Nah HJ, Chon CY, Han KH.
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time-dependent manner by altering the expression of genes characteristics and prognostic factors. J Cancer Res Clin Oncol
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regulation. Various other treatment modalities have been 7. Chen CY, Chau GY, Yen SH, Hsieh YH, Chao Y, Chi KH, Li CP,
[10]
reported for bone metastasis such as chemoembolization as Chang FY, Lee SD. Life-threatening haemorrhage from a sternal
metastatic hepatocellular carcinoma. J Gastroenterol Hepatol
for a primary HCC, systemic chemotherapy, radiotherapy 2000;15:684-7.
or surgical resection. Unfortunately, prognosis remains 8. Huang SF, Wu RC, Chang JTC, Chan SC, Liao CT, Chen IH, Yeh
[6]
poor. Median survival for HCC with bone metastasis is CN. Intractable bleeding from solitary mandibular metastasis of
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9. Qureshi SS, Shrikhande SV, Borges AM, Shukla PJ. Chest wall
To conclude, we here report an unusual presentation of metastasis from unknown primary site of hepatocellular carcinoma.
J Postgrad Med 2005;51:41-2.
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Journal of Cancer Metastasis and Treatment ¦ Volume 2 ¦ Issue 1 ¦ January 15, 2016 ¦ 43