Rare case of hepatocellular carcinoma metastasis to urinary bladder: A case report

Abstract

BACKGROUND Hepatocellular carcinoma (HCC) is a primary liver cancer with high prevalence and mortality. There are many cases of advanced HCC at the time of diagnosis. Treatment methods and prognosis are different depends on whether metastasis is present. Thus, it is necessary to make an accurate evaluation at the time of diagnosis. Extrahepatic metastases of HCC usually occur through hematogenous spread or through adjacent organs such as the peritoneum. Metastasis to the urinary bladder alone is rare. Here, we report a rare case of biopsy-proven solitary metastasis of HCC to the bladder in a 60-year-old woman. CASE SUMMARY A 60-year-old female patient was found to be positive for hepatitis B surface antigen by chance after abdominal ultrasonography showed abnormal findings. Thus, liver dynamic computed tomography (CT) was performed. The patient visited the hospital for further examination. Ultrasound and CT showed 3.6 cm sized arterial enhancing mass in segment 5 and an infiltrative mass in segment 8. The patient was diagnosed with HCC through liver dynamic magnetic resonance imaging and liver biopsy. Afterwards, she underwent two transcatheter arterial chemoembolizations within five months for HCC. During follow-up, a newly appeared bladder tumor was found on liver dynamic CT. She underwent transurethral resection of the bladder tumor for diagnosis and treatment. The tissue was confirmed as metastatic HCC. CONCLUSION Although rare, metastasis to urinary bladder from HCC can occur without evidence of other distant metastases. Thus, regular follow-up imaging examination and clinical attention are required.

A case of urinary bladder metastasis of hepatocellular carcinoma following use of immunotherapy/tyrosine kinase inhibitor

“…Compared to the two previous cases, 3,4 our patient was diagnosed with a bladder tumor with advanced-stage HCC. Chung et al 5 also reported a case of advanced HCC with bladder metastasis.…”

“…Compared to the two previous cases, 3,4 our patient was diagnosed with a bladder tumor with advanced‐stage HCC. Chung et al 5 .…”

“…These cases suggest that bladder metastasis of HCC can occur as a solitary metastasis or multiple metastases. Primary bladder cancer and HCC metastases to the urinary bladder have similar morphology in imaging and cystoscopy 3,5 . Therefore, histological evaluation is necessary to distinguish between these entities.…”

“…Only a few cases of HCC with bladder metastases have previously been reported. [3][4][5] Kim et al 3 reported a case of HCC with urinary bladder metastasis. The patient underwent transcatheter arterial chemoembolization for HCC as primary therapy.…”

“…The lungs, bones, lymph nodes, and adrenal glands are the primary sites of extrahepatic metastases. 2 The urinary bladder is an atypical location of HCC metastasis, 3 with only a few cases reported previously. 3 , 4 , 5 Here we present a case of bladder metastasis in a patient with HCC who was treated with an IO/TKI.…”