The Psoas Muscle as an Unusual Site for Metastasis of Hepatocellular Carcinoma: Report of a Case

Abstract

Extrahepatic metastasis of hepatocellular carcinoma (HCC) is an indicator of a poor prognosis. The most common extrahepatic sites of metastatic HCC are the lungs, intra-abdominal organs, and bone. Metastasis of carcinoma from any site to skeletal muscle is rare, and to the best of our knowledge, the hematogenous spread of HCC to skeletal muscle has never been described before. We report a case of isolated metastasis in the left side of the psoas muscle, which was found 1 year after trisegmentectomy. The lesion was successfully resected with the muscle, and no other metastatic lesions have been found in 5 months of follow-up.

Muscle metastasis from hepatocellular carcinoma in a patient treated with TACE

“…It has been reported after fine-needle aspiration liver biopsy (0.3e2.0%), percutaneous ethanol injections (0.6e 2.0%), and radiofrequency thermal ablation (0.6%), but to our knowledge, this complication has never been described after TACE. This is also the first report of muscle metastasis from HCC after a therapeutic intervention [5].…”

Hepatocellular carcinoma with pharyngeal metastasis: Report of a case

“…9 Hepatocellular carcinoma often results in hematogenous metastasis to organs such as the lung, adrenal gland, bone, 11 and other unusual sites, including skeletal muscle. 12 Tumor cells may be distributed to the pharyngeal region through the systemic circulation. Batson 13 also described another route involving the paravertebral venous plexus, which lacks valves and may be capable of bypassing venous systems such as the pulmonary, caval, and portal veins.…”

Hepatocellular carcinoma with disseminated skeletal muscle metastasis

“…Other unusual musculoskeletal sites of extrahepatic metastasis have also been reported in the literature. These include reports by Subramaniam et al., Furumoto et al., and Wu et al., who reported extrahepatic metastasis to the left iliacus, intercostal muscle, and psoas muscle, respectively (4–6). Adrenal gland involvement was reported to occur in up to 8.8% of patients by Uchino et al.…”