scholarly journals Metastasis of hepatocellular carcinoma presented as a tumor of the maxillary sinus and retrobulbar tumor

2011 ◽  
Vol 68 (4) ◽  
pp. 359-362 ◽  
Author(s):  
Daniela Kolarevic ◽  
Zorica Tomasevic ◽  
Ivan Boricic ◽  
Dejan Rasic ◽  
Natasa Andjelic-Dekic ◽  
...  

Introduction. Hepatocellular carcinoma (HCC) is the most frequent primary malignant tumor of the liver. It is usually seen in the 6th and 7th decades of life and chronic hepatitis B is the most frequent cause. Extrahepatic metastasis of HCC is an indicator of a poor prognosis and the most common sites are lungs, bones, lymph nodes, kidneys and adrenal glands. We reported a case of isolated metastasis in the right maxilla, which had been found initially, before the tumor in the liver was diagnosed. Case report. A 70-year-old man underwent dental surgery of the upper right molar. Prolonged bleeding control was difficult for up to two weeks, so the biopsy was performed. Histopathological analysis revealed a metastatic hepatocellular carcinoma. Computerized tomography (CT) of the abdomen revealed a diffusely heterogeneous liver parenchyma with irregular borders and two foci of mass lesions. There were metastasis in the spleen and also two pathological retroperitoneal lymph nodes were detected, but no ascit, liver cirrhosis, cholestasis or portal vein thrombosis were seen. CT of the orbital and maxillary regions revealed a tumor mass in the right maxillary sinus, spreading to the alveolar sinus, nasal cavity and partially infratemporal space. A tumor mass was in the right orbit as well, infiltrating the surrounding bones and muscles. Clinically, there was proptosis of the right eye accompanied by amaurosis. The treatment started with chemotherapy based on 5-fluorouracil (sorafenib was not available). After three cycles, control CTs showed a stable disease in the liver, but progression in the right maxillary sinus and orbit. Enucleation of the right eye was performed and postoperative radiotherapy was planed. The patient deteriorated rapidly and died, about 6 months after the disease had been diagnosed. Conclusion. Extrahepatic metastasis of HCC represents a progressive phase of the disease with poor prognosis, so the main aim of the treatment should be palliation and care of symptoms.

2017 ◽  
Vol 6 (7) ◽  
pp. 205846011771670
Author(s):  
Ezamin Abdul Rahim ◽  
Mohamad SF Noh ◽  
Nur A Ngah ◽  
Mohamad S Suraini ◽  
Mubarak M Yusof

Hepatocellular carcinoma (HCC) is the commonest primary tumor of the liver and carries a poor prognosis when diagnosed late or left untreated. Treatment relies heavily on the stage of the tumor when diagnosed. Extrahepatic metastasis is known to occur; these are mainly reported via autopsy studies or isolated case reports. Knowledge of extrahepatic metastasis is crucial in order to avoid unnecessary surgery. We report a rare case of a patient at our center, diagnosed to have HCC, who underwent treatment successfully, only to come back with extrahepatic metastasis to the skeletal muscles.


2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Kiyonori Tanoue ◽  
Yota Kawasaki ◽  
Yoichi Yamasaki ◽  
Satoshi Iino ◽  
Masahiko Sakoda ◽  
...  

Abstract Background Hepatocellular carcinoma (HCC) patients with metastases to the cervical lymph nodes are extremely rare, and its clinical course is characterized by rapidly progressive disease. Hence, there have been no reports of metastatic cervical lymph node recurrence indicated after a long postoperative surveillance period. Case presentation The patient was a 63-year-old male who underwent right hepatectomy for HCC of the right upper lobe. Three years after resection, metastatic lymph node recurrence was detected in the subdiaphragm, superior mediastinum, and right cervical lymph nodes. The patient underwent excisional biopsy of the cervical lymph node, followed by molecular-targeted therapy and radiation therapy. Lenvatinib reduced the size of all metastatic lymph nodes and the patient survived for a relatively long period of 43 months after the recurrence was detected. Conclusions After resection of HCC in the right upper lobe, there is the possibility of metastatic lymph node recurrence in unusual sites, including the cervical region, and lenvatinib may be effective in those recurrences.


2017 ◽  
Vol 11 (2) ◽  
pp. 416-421 ◽  
Author(s):  
Mashal Salehi ◽  
The Yee ◽  
Eric Alatevi ◽  
Yamin Thein

Intracavitary cardiac extension remains an unusual site of extrahepatic metastasis in patients with hepatocellular carcinoma. While patients can present with signs and symptoms suggestive of right-sided heart failure, it may be totally asymptomatic, which is very rare with only a few cases reported so far. Also, cardiac metastasis is of great prognostic importance as patients with intracardiac metastasis can have an extremely poor prognosis. Here, we present the case of a 52-year-old male patient with advanced hepatocellular carcinoma, with an incidentally found tumor thrombus extending from the inferior vena cava to the right atrium, protruding through the tricuspid valve into the right ventricle, on routine echocardiography. The patient did not have any signs or symptoms of heart involvement and unfortunately died on the 18th day of the hospital stay.


2019 ◽  
Vol 48 ◽  
Author(s):  
Andréia Vitor Couto de Amaral ◽  
Francine Mucha ◽  
Igor Borges De Oliveira ◽  
Camila Franco De Carvalho ◽  
Wanessa Ferreira De Ataide ◽  
...  

Background: Canine transmissible venereal tumor (CTVT) is a peculiar neoplasm resulting from the transmission of host cancerous cells to another canid by implantation. Transmission occurs among reproductive age dogs, especially those with unrestricted sexual activity. It usually occurs on the external genitalia of dogs and other areas are unusual. However, implants have been described in injured mucosa, as well as metastases in lymph nodes, spleen, skin, anus and perianal space, oral mucosa, nasal mucosa, eyeball and brain. The purpose of this report is to describe the first case of exclusively extragenital ocular CTVT in a prepubescent female dog.Case: A 6-month-old mixed-breed, non-spayed and prepubescent female dog, showing a fast-growing reddish-colored mass in the right eye (RE), was examined. Blepharospasm, mild serosanguineous secretion, chemosis and a smooth surface reddish mass with 2.5 cm in length occupying the orbital area were observed during physical examination, impairing the visualization of the right eyeball. For ocular ultrasonography examination of the affected eye, acepromazine was used (0.03 mg/kg) associated with methadone (0.3 mg/kg) intramuscularly, and propofol (4 mg/kg) for induction and 0.2 mg/kg for maintenance, intravenously. Ultrasonography examination evidenced an amorphous hyperechogenic structure, medial to the RE, with homogeneous echotexture, punctiform vascularization to amplitude Doppler (Power Doppler), measuring 2.8 cm in length and 1.4 cm in diameter, causing eyeball distortion and rejection. Based on ultrasonography results and with the patient still anesthetized, an incisional biopsy of the peribulbar mass was performed with a 5 mm disposable punch. The final CTVT diagnosis was possible after histopathological analysis. No more CTVT nodules were found, especially in the vulva, which had a prepubescent appearance, consistent with age. Treatment with 4 sessions of chemotherapy with vincristine sulfate resulted in complete remission of the tumor mass. In the second session, it was already possible to visualize the eyeball with a significant remission of the tumor mass, ruling out neoplastic exceresis. At this time, threat response, normal direct and consensual photopupillary reflexes, normal eyelid reflex, corneal surface without slit lamp biomicroscopy and fluorescein staining were present in the RE. Nevertheless, there were mild diffuse corneal edema and slight ciliary injection. One percent prednisolone eye drops (8/8 h) and tobramycin eye drops (6/6 h) were prescribed for 1 week. In the fourth session of chemotherapy, no changes were observed in the RE.Discussion: In the present case, the diagnosis of CPVD in a prepubertal patient, primary orbital TVTV, and the fact that the structure of the eye bulb and visual function remain intact, even with the significant volume of orbital neoplasia, are highlighted. A single report of skin CTVT in an 11-month-old prepubescent female dog was found. It is important to emphasize that CTVT is typically of dogs of reproductive age that have genital masses. Usually, extragenital masses are related to the act of licking, scratching, biting or sniffing the primary tumor (self-implantation), or rarely, by metastasis, a fact not observed in the present report, since the ocular mass was the only manifestation. Treatment was conducted according to indications of the literature. Four injections of vincristine sulfate were necessary, observing complete remission of the tumor mass with no relapse after 30 days. In this case report, it was possible to observe that CTVT may reveal unusual behaviors regarding epidemiology, which, added to the rare form of exclusively extragenital ocular clinical manifestation, impose a diagnostic challenge, making the histopathological examination an important tool for diagnosis.


2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Hassen Mohammed ◽  
Rashid Sheikh ◽  
Waheed Rahman ◽  
Sally Sheta ◽  
Zeynel Dogan

Hepatocellular carcinoma (HCC) is a primary malignancy of the liver with up to half of cases suffering from extrahepatic metastasis in the later stages of the disease. Commonly reported and encountered metastatic sites include the lymph nodes, lung, bone, and adrenal glands. This is an effort to throw a spotlight on a rare case of metastatic HCC which presented to us as two distinct lesions in the nose. It focuses on the presentation and the steps that were taken to reach this rare and unusual diagnosis. It sparks interest from a clinical and histopathology perspective. Our cynosure is the findings of the case coupled with a probe on the possible routes of spread of HCC to sinonasal region.


2021 ◽  
Vol 15 (2) ◽  
pp. 95
Author(s):  
Steven Octavianus ◽  
Henry Kodrat

Introduction: Salivary gland cancer is an uncommon malignancy in the head and neck. The most common histopathologic type in salivary gland malignancies is mucoepidermoid carcinoma (MEC). Radiotherapy has a role in salivary gland malignancy, especially in inoperable cases and postoperative settings. Definitive or postoperative radiotherapy with or without chemotherapy can improve locoregional control (LRC) in patients with parotid mucoepidermoid carcinoma. Case Presentation: We report a case of a 77-year-old male with inoperable MEC of the right parotid, who received definitive radiotherapy. From the three-month evaluation after radiation therapy, we found a significant reduction in the tumor mass. Conclusions: Surgery remains the treatment of choice for patients with salivary gland malignancies. Definitive radiotherapy can be a treatment modality in inoperable cases or patients who refuse surgery. Although the result is not satisfactory, radiotherapy can still give clinical benefits to patients.


2019 ◽  
Vol 47 (11) ◽  
pp. 5824-5830
Author(s):  
Yu Cui ◽  
Xiang-Yan Cui ◽  
Yu Wu ◽  
Wan-Zhong Yin ◽  
Zhan-Peng Zhu

Small cell lung cancer metastasizing to the parotid gland is very rare and only a few cases have been reported. A 64-year-old man presented with a painless mass and peripheral facial paralysis. Neck ultrasound identified a solid mass in the right parotid gland with enlargement of the lymph nodes in the gland and the right submandibular lymph nodes. Lung computed tomography imaging demonstrated abnormalities in the upper and middle lobes of the right lung and intermediate bronchus, with obstructive pneumonia, as well as enlargement of the right hilar and mediastinal lymph nodes. Postoperative histopathological analysis identified small cell carcinoma in the right parotid gland with involvement of the right neck lymph nodes (one of eight). Bronchoscopy was performed and immunohistochemical analysis of the specimen demonstrated possible metastasis of small cell lung cancer to the parotid gland. From postoperative day 15, the patient started to undergo six cycles of an adjuvant chemotherapy regimen. No complications of the chemotherapy regimen were observed after three cycles. Treatment and follow-up are ongoing.


Author(s):  
Manjit Sarma ◽  
Subramanyam Padma ◽  
Parvathy Pavithran ◽  
Vijay Harish Somasundaram ◽  
Palanisamy Shanmuga Sundaram

Abstract Background To determine locations, relative frequencies, imaging features, and pattern of distribution of extrahepatic metastasis from hepatocellular carcinoma (HCC) on 2-deoxy-2-[fluorine-18]fluoro-D-glucose (18F-FDG) PET CT. Methods FDG PET CT scans of 224 consecutive patients of HCC acquired between 2010 and 2018 were reviewed. Fifty-six patients detected with extrahepatic metastasis on FDG PET CT were retrospectively analyzed. Findings were correlated with prior/follow-up imaging studies, clinical findings, FNAC, or biopsy findings whenever available. Descriptive analysis of location, relative frequencies, imaging features, and pattern of distribution of extrahepatic metastasis was done. Results Commonest were metastatic pulmonary nodules (55.3% patients), most of them being well-defined solid lesions (53.5%) with bilateral involvement in 44.6% patients and lower lobes of lungs along with other lobes being more frequently involved (41.0% patients). While in 7.14% patients lung nodules were FDG avid, 23.2% patients had both FDG avid and non-avid pulmonary nodules. Second most common were regional metastatic lymph nodes in 44.65% of patients seen at aortocaval (25%), paraaortic (23.21%), portocaval (21.4%), and left gastric nodal (17.8% of patients) stations. Twenty-five percent of patients had FDG avid lymph nodes and 5.36% patients had both FDG avid and FDG non-avid lymph nodes. Distant metastatic lymph nodes were third most common in 39.2% of patients seen at paratracheal (2.5%), juxtaphrenic (8.9%), and mesenteric lymphnodal (7.1%) stations. Twenty-five percent of patients had FDG avid lymph nodes while 5.36% patients had both FDG avid and FDG non-avid lymph nodes. Skeletal involvement was seen in 32.1% of patients. Commonest sites are vertebrae (16.7%), pelvis (14.2%), and ribs (10.7% patients). Six out of 7 patients had unilateral adrenal gland involvement. Bilateral adrenal gland involvement was seen in 1 patient. FDG non-avid peritoneal/omental metastases was seen in 2 patients. Brain, spleen, and muscle metastatic lesions were seen in 1 patient each out of 56 patients (1.79%). Conclusions Lungs, regional and distant lymph nodes and skeleton are the most frequently involved sites of extrahepatic metastatic hepatocellular carcinoma. Adrenal glands, muscles, brain and peritoneum are also involved but to a lesser extent.


2019 ◽  
Vol 19 (4) ◽  
pp. 414-420
Author(s):  
Payam Mehrian ◽  
Abtin Doroudinia ◽  
Moghadaseh Shams ◽  
Niloufar Alizadeh

Background: Intrathoracic Lymphadenopathy (ITLN) in Human Immunodeficiency Virus (HIV) infected patients may have various etiologies and prognoses. Etiologies of ITLN can be distinguished based on the distribution of enlarged lymph nodes. Sometimes tuberculosis (TB) is the first sign of underlying HIV infection. Objective: We sought to determine ITLN distribution and associated pulmonary findings in TB/HIV co-infection using Computed Tomography (CT) scan. Methods: In this retrospective, observational, cross-sectional study, chest CT scans of 52 patients with TB/HIV co-infection were assessed for enlarged intrathoracic lymph nodes (>10 mm in short axis diameter), lymphadenopathy (LAP) distribution, calcification, conglomeration, the presence of hypodense center and associated pulmonary abnormalities. LAP distribution was compared in TB/HIV co-infection with isolated TB infection. Results: Mediastinal and/or hilar LAP were seen in 53.8% of TB/HIV co-infection patients. In all cases, LAP was multinational. The most frequent stations were right lower paratracheal and subcarinal stations. Lymph node conglomeration, hypodense center and calcification were noted in 25%, 21.4% and 3.5% of patients, respectively. LAP distribution was the same as that in patients with isolated TB infection except for the right hilar, right upper paratracheal and prevascular stations. All patients with mediastinal and/or hilar adenopathy had associated pulmonary abnormalities. Conclusion: All patients with TB/HIV co-infection and mediastinal and/or hilar adenopathy had associated pulmonary abnormalities. Superior mediastinal lymph nodes were less commonly affected in TB/HIV co-infection than isolated TB.


Sign in / Sign up

Export Citation Format

Share Document