Cutaneous Metastases from Primary Hepatobiliary Tumors as the First Sign of Tumor Recurrence following Liver Transplantation

Abstract

Cutaneous metastasis from hepatobiliary tumors is a rare event, especially following liver transplantation. We report our experience with two cases of cutaneous metastases from both hepatocellular carcinoma and mixed hepatocellular/cholangiocarcinoma following liver transplantation, along with a review of the literature.

Cutaneous metastasis of hepatocellular carcinoma following liver transplantation

“…There, the cutaneous metastases represented the first signs of tumor recurrence. One patient died within 4 months and the other patient was still alive at the time of publication, 6 months later …”

“…Cutaneous hepatocellular carcinoma metastases occur in 2.7% to 3.4% of HCCs, but are extremely rare following orthotopic liver transplantation, with only three reported cases in the literature . Cutaneous HCC lesions may be the first sign of underlying malignancy or may be evidence of recurrence, but in all cases indicate advanced stage disease.…”

“…Cutaneous metastases from hepatocellular carcinoma (HCC) after orthotopic liver transplantation (OLT) are extremely rare, with only three reported cases in the literature . On the other hand, around 50 cases of cutaneous HCC metastases have been reported.…”

Dermoscopy of cutaneous metastases from primary hepatocellular carcinoma

“…Cutaneous metastases from HCC are relatively rare, accounting for only 0.2% to 2.7% of all cutaneous metastases. [1] The majority of cutaneous metastases from HCC originate from needle tracks or surgical wound contamination; non-iatrogenic metastasis was rare. One possible explanation is that HCC invades the systemic circulation less frequently than it invades the portal veins.…”

Cutaneous manifestations of hepatocellular cancer (HCC)

“…HCC metastatic skin lesions are extremely rare; however, localized skin lesion should make clinicians explore and be mindful of this diagnosis. These lesions may occur as an early primary HCC cutaneous manifestation or as a marker of cancer relapse following therapeutic resection and/or liver transplantation [6]. Most reported cases are sporadic lesions resembling pyogenic granulomas or localized dermal skin deposits of cancer cells.…”