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Int J Clin Exp Pathol 2013;6(5):816-820

Original Article
Unusual extrahepatic metastatic sites from hepatocellular carcinoma

Tadashi Terada, Hirotoshi Maruo

Department of Pathology and Surgery, Shizuoka City Shimizu Hospital, Shizuoka, Japan

Received November 25, 2012; Accepted March 27, 2013; Epub April 15, 2013; Published May 1, 2013

Abstract: The author examined unusual extrahepatic metastatic sites from liver hepatocellular carcinomas (HCCs) in autopsy and surgical
files at our laboratory in the last 10 years. In autopsy cases (n=31), extrahepatic metastases were present in 21 cases (68%). The most
common metastatic sites were lung (n=18). Unusual extrahepatic metastatic sites in the autopsy series were abdominal regional lymph nodes
(n=6), bones (n=5), diaphragma (n=2), pancreas (n=2), gall bladder (n=1), stomach (n=1), colon (n=1), adrenal gland (n=1), pleura (n=1),
peritoneum (n=1), cervical lymph nodes (n=1), and shoulder soft tissue (n=1). In surgical cases (n=21), in which extrahepatic tumors were
excised, the lung was the most common, and accounted for 16 cases. The unusual extrahepatic metastatic sites in the surgical series were
bones (n=2), brain (n=1), skin (n=1), and oral cavity (n=1). Immunohistochemical demonstration of HepPar1 and AFP were recognized in 12 of
12 surgical cases examined and 8 of the 12 surgical cases examined, respectively. Cytokeratin 8 and 18 were expressed in 6 of 6 surgical
cases and 7 of 7 surgical cases examined. These data shows that HCC can metastasize in various organs other than the lung, and HepPar1
and AFP were good markers of extrahepatic metastases of these unusual sites of metastatic foci from HCC. (IJCEP1211033)

Keyword: Hepatocellular carcinoma, metastasis, autopsy, surgery, pathology

Address correspondence to: Dr. Tadashi Terada, Department of Pathology, Shizuoka City Shimizu Hospital, Miyakami 1231 Shimizu-Ku,
Shizuoka 424-8636, Japan. Phone: 81-54-336-1111; Fax: 81-54-336-1315; E-mail: piyo0111jp@yahoo.co.jp