Indian Journal of Nuclear Medicine
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Year : 2013  |  Volume : 28  |  Issue : 3  |  Page : 171-172

Evaluation of bone metastasis as the first presentation of hepatocellular carcinoma using 18-fluorodeoxyglucose positron emission tomography-computed tomography

1 Department of Nuclear Medicine, Ataturk University, Erzurum, Turkey
2 Department of Pathology, Medical School, Ataturk University, Erzurum, Turkey

Correspondence Address:
Arif Kursad Ayan
Department of Nuclear Medicine, Medical School, Ataturk University, 25240 Erzurum
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0972-3919.119552

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We report a case of a patient with hepatocellular carcinoma (HCC) who presented with back pain related to bone metastasis. HCC metastasizes by hematogenous and lymphatic routes commonly to the lungs, regional lymph nodes, kidney, bone marrow and adrenals. In this extremely rare case, the patient had no known liver disease, but presented with liver lesions and multiple bone lesions involving vertebrae, ribs, pelvic bones and left femur with associated expansile soft-tissue components. These bone lesions were first detected from a positron emission tomography scan. Pathological examination of biopsy material taken from the left eighth rib confirmed metastatic HCC. In conclusion, if a patient has expansile osteolytic bone lesions, bone metastasis from HCC should be included in the differential diagnosis.

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