Abstract
Hepatocellular carcinoma (HCC) is the most common primary malignancy of the liver. Its incidence is increasing and has a very high mortality rate 1 . It may be asymptomatic at presentation or may present with florid metastasis. Here we report a case of a 68 year old gentleman who presented with swelling and numbness on right side of the face and bleeding from right ear following extraction of tooth. Investigations revealed a locally advanced masticator space lesion positive for malignant cells. PET CT scan revealed a FDG avid hypoattenuating SOL in liver which on further investigations was found to be the primary HCC metastasizing to maxillofacial region.
Keywords: maxillofacial, hepatic, metastasis, adenocarcinoma.
References
- Sahil Mittal, Hashem B. El-Serag. Epidemiology of HCC: Consider the Population J Clin Gastroenterol. 2013 Jul; 47(0): S2–S6.
- Katyal, J.H. Oliver 3rd, M.S. Peterson, JV. Ferris, B.S. Carr, R.L. Baron. Extrahepatic metastases of hepatocellular carcinoma.Radiology. 216 (3) (2000), pp. 698-703
- Anthony Hepatocellular carcinoma: an overview. Histopathology, 39 (2) (2001), pp. 109-118
- R. Pires, R. Sagarra, M.E. Corrêa, C.M. Pereira, P.A. Vargas, M.A. Lopes. Oral metastasis of a hepatocellular carcinoma. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 97 (3) (2004), pp. 359-368
- Der-Lin, K. S. Cheng, C. H. Tsai, C. L. Chen, and M. H. Tsai, “Metastatic hepatocellular carcinoma in the nasal septum: report of a case,” Journal of the Formosan Medical Association, vol. 101, no. 10, pp. 715–718, 2002.
- S. Hwang, Y. S. Kim, Y. C. Koo, D. W. Lee, and C. H. Kim, “A case of extrahepatic metastasis of hepatocellular carcinoma in the nasal septum managed with endoscopic resection.” Journal of Rhinology, vol. 19, no. 1, pp. 74–76, 2012.
- Lior Charach ,Lior Zusmanovitch, Gideon Charach. Hepatocellular carcinoma. part 2: clinical presentation and diagnosis.EMJ Hepatol. 2017;5 (1): 81-88.
- Forner, J.M. Llovet, J.Bruix. Hepatocellular carcinoma. Lancet 379(9822)(2012),pp.1245-1255.
- Ramon Ramirez, J. Seoane , J.Montero, G.C.Esparza Gomez, R. Cerero. Isolated gingival metastasis from hepatocellular carcinoma mimicking a pyogenic granuloma. J Clin Periodontol, 30 (10) (2003), pp. 926-929
- Oida Y., Ishii M., Dowaki S., Tobita K., Ohtani Y., Imaizumi T. Hepatocellular carcinoma with metastasis to the pharynx: report of a case. Tokai Journal of Experimental and Clinical Medicine. 2005;30(1):31–34
- Borg M.F. Parotid gland as an initial site of metastasis.Australian Radiology. 2004;48(1):88-92.
- Nuyens M., Schupbach J., Stauffer E., Zbaren P. Metastatic disease to the parotid gland. Otolaryngology – Head and Neck Surgery. 2006;135(6):844–848.
- Dargent J.L., Deplace J., Schneider E., Morales J., Kentos A., Willemart S. Hepatocellular carcinoma metastatic to the parotid gland: initial diagnosis by fine needle aspiration biopsy. Acta Cytologica. 1998;42(3):824–826.
- Romanas M.M., Cherian R., McGregor D.H., Wu Y., May C.L., Baranda J.C. Hepatocellular carcinoma diagnosed by fine-needle aspiration of the parotid gland. Diagnostic Cytopathology. 2004; 30(6):401–405.
- Fan Z, Van de Rijn M, Montgomery K, Rouse RV. Hep par 1 antibody stain for the differential diagnosis of hepatocellular carcinoma: 676 tumors tested using tissue microarrays and conventional tissue sections.Mod Pathol 2003 Feb;16(2):137-44.
- Hanif R, Mansoor S. Hep par-1: a novel immunohistochemical marker for differentiating hepatocellular carcinoma from metastatic carcinoma.J Coll Physicians Surg Pak. 2014 Mar ; 24(3): 186-9.
Corresponding Author
Aditi Tanwar
Radiation Oncology, Dharamshila Narayana Superspeciality Hospital, Vasundhara Enclave, Delhi-110096, India
DOI: https://dx.doi.org/10.18535/jmscr/v7i6.78
