Cutaneous metastases from hepatomas

Abstract

Three cases of hepatomas metastasized to the skin in a series of 88 patients with hepatomas. The skin metastases differed from the usual dermal nodules, such as fibromas, inflammatory granulomas, and adnexal tumors, by their rather sudden appearance as solitary or multiple, nonulcerative, painless, firm, reddish-blue nodules on the scalp, chest, and shoulder. Biopsies of these nodules were necessary in order to confirm the diagnosis of the cutaneous metastases, which appeared before the primary tumors were recognized. Microscopically, the skin tumors were adenocarcinomas in two instances and hepatocellular carcinoma in one. The skin metastases were a late manifestation of the primary tumors; the patients died within three weeks to six months after the appearance of skin tumors. Necropsies showed widespread metastases.

Cutaneous features seen in primary liver cell (Hepatocellular) carcinoma patients at a University Teaching Hospital in Nigeria

“…There is however little practical purpose in distinguishing between the two types since both may be found in different parts of the same tumor and the clinical course are similar. Skin features documented with PLCC include cutaneous porphyria [7,8], pityriasis rotunda [9,10], papules and nodules to the skin from metastasis [11,12]. Some features found in this study point to possible underlying or background liver cirrhosis (LC) before the transformation to malignancy.…”

Systemic metastasis of hepatocellular carcinoma responsive to multidisciplinary treatment including debulking surgery

“…Cutaneous metastases originating from HCC appear as rather rapidly growing nodules, usually on the scalp, chest, and shoulder. They appear as single or multiple, firm, painless, nonulcerative, reddish-blue nodules, measuring 1 to 2.5 cm in diameter [8]. Especially in cases of skin metastasis of HCC caused by systemic spread of disease, indicating the strong possibility of metastases in other regions of the body, the prognosis is dismal [5,6].…”

“…The most common site for extrahepatic metastasis of HCC is the lung, followed by regional lymph node, and bone [1,2]. Metastatic skin lesion of HCC is rare, accounting for less than 0.8% of all metastatic cutaneous tumors and occurring in 2.7%-3.4% of all HCCs [3,4]. Skin metastasis is a sign of poor prognosis, indicating the strong possibility of metastases in other regions of the body, and points to a median survival time of less than five months [5,6].…”

Cutaneous Metastasis of Occult Hepatocellular Carcinoma

“…11 Skin metastases of HCC are very rare, with an incidence of around 3%. 2 The head appears to be the most frequent site of cutaneous and subcutaneous involvement. 4 Paradoxically, most of these metastases occur without lung involvement.…”

“…The latter are located mainly in the lungs and the porta hepatis lymph nodes. 1 Skin metastases from HCC are very rare 2 and represented only 0.8% of all known cutaneous metastases in a recent large series. 3 The most frequent sites of cutaneous metastasis in HCC appear to be the head.…”