Abstract:
Hepatocellular carcinoma (HCC) is the most common primary tumor of the liver, and this is the 5th most common cancer in the world. Bone metastasis from hepatocellular carcinoma is an extremely rare condition, and most of the time, it is overlooked during baseline metastatic workup. In 5% to 15% of cases, distant metastasis is present at the time of diagnosis. In this report, we present a case of HCC with chronic liver disease with bony secondaries involving sacral vertebrae and hard palate. A 51 years old male patient came to us with the clinical presentation of fatigue, low back pain, and ulceration in the oral cavity. He was HBsAg positive for the last 15 years, and space occupying lesion was found in the liver in Ultrasound. Alpha-fetoprotein was markedly raised. MRI of the spine revealed metastatic lesions involving multiple sacral vertebrae. Biopsy from the oral cavity (hard palate) showed metastatic hepatocellular carcinoma. We reported the case because hepatocellular carcinoma with bone metastasis is uncommon but should be considered as one of the differential diagnoses in patients presenting with multiple bone metastases.